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OBJECTIVE: Recombinant human granulocyte colony-stimulating factor (G-CSF) has been used for treatment of febrile neutropenia in systemic lupus erythematosus (SLE) and other systemic rheumatic diseases. We describe 2 patients with SLE with disease flares with irreversible loss of renal function in association with G-CSF therapy. Eighteen patients with SLE treated with G-CSF for neutropenia have been reported, of whom 4 developed mild disease flares or cutaneous vasculitis. Our experience suggests that G-CSF therapy should be used with considerable caution in patients with SLE.