Is there a role for G-CSF treatment for SLE patients with persistent neutropenia?

There may be a role for G-CSF for treatment of SLE-related neutropenia, though would recommend using with caution only for severe neutropenia (ANC less than 500) and at lowest dose. The use of G-CSF has been looked at in small case series over the years for both SLE patients with neutropenia and Felty's patients showing benefit but with risk for disease flare as well as leukocytoclastic vasculitis (Vasiliu et al., PMID 16832843 and Hellmich et al, PMID 10553980). The risk for flare and other complications were found to be less when the lowest dose of G-CSF was used. In practice, I rarely see SLE patients with severe enough neutropenia to warrant G-CSF and if I do, I am more often worried about it being related to medications. I would recomm...