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Gemcitabine is a nucleoside analogue used widely across haemato-oncology. Side effects are generally predictable, and typically consist of cytopenia, nausea, and infection. As the present case clearly demonstrates, gemcitabine is in rare cases associated with life-threatening large vessel vasculitis, which can involve the aorta. It is important to consider gemcitabine-induced vasculitis in non-specifically unwell patients with raised inflammatory markers and fever of unknown origin, with or without signs of vascular compromise. Early recognition, cessation of gemcitabine therapy, and high-dose steroids are critical for a good outcome. PET CT is valuable to diagnose large vessel vasculitis and monitor treatment response.

Original publication




Journal article


Int J Hematol

Publication Date





798 - 800


Antimetabolites, Antineoplastic, Aorta, Thoracic, Deoxycytidine, Female, Fluorodeoxyglucose F18, Humans, Iliac Artery, Middle Aged, Positron-Emission Tomography, Tomography, X-Ray Computed, Vasculitis