Six patients with breast cancer were identified who had suspected chemotherapy or G-CSF induced large vessel vasculitis (LVV) from the University Hospitals of Helsinki and Turku, Finland. This kind of adverse drug reaction is not generally known. The purpose of this article is to evaluate the rare connection of LVV and anticancer therapy by describing our patient cases and through a systematic review of the literature.

Two separate systematic literature searches were conducted in MEDLINE via PubMed to find reports of cancer patients receiving chemotherapy or G-CSF or both, prior to onset of new LVV. The first search was performed in May 2018 by using comprehensive search terms for breast cancer, chemotherapy and LVV. The second search was performed in December 2018 to assess the connection between G-CSF and LVV by using comprehensive keywords for LVV and G-CSF.

The first literature search identified 12 and the second search identified 4 patient cases matching our criteria. Two of the patients described in the literature were suffering from breast cancer and had very similar clinical representation as the cases presented in this paper. Large vessel vasculitis is a possible serious rare adverse event associated with chemotherapy and G-CSF. The signs and symptoms of LVV are non-specific, and this condition could be underdiagnosed and should be kept in mind when treating oncological patients. Successful management requires early identification and cessation of the drug. When diagnosed and treated properly, the recovery is usually fast.