Paradoxical reaction to rituximab in patients with pemphigus: a report of 10 cases

Nili, Ali; Tavakolpour, Soheil; Mahmoudi, Hamidreza; Noormohammadpour, Pedram; Balighi, Kamran; Daneshpazhooh, Maryam

doi:10.1080/08923973.2020.1717526

Cited by 23 publications

(24 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Exacerbation of disease following the first infusion of rituximab in the commonly used rheumatoid arthritis protocol (1 g rituximab, 2 weeks apart) was recently reviewed by Nili et al , 3 who found an exacerbation rate of 1.12 and 0.38% per patient and per cycle, though the frequency was higher in our study. Exacerbation has been noted with the use of both the original product and biosimilars.…”

Section: Parameter (Mean) Cases (N = 18) Controls (N = 50) P Valuecontrasting

confidence: 57%

See 1 more Smart Citation

A retrospective case–control study of clinical factors associated with paradoxical exacerbation of pemphigus vulgaris following rituximab infusion

2020

View full text Add to dashboard Cite

Lastly, evidence suggests that both AA and FFA have a genetic predisposition. Genome-wide association studies have identified polymorphisms that may be involved in the pathogenesis of each condition, although a common one to the two conditions has not yet been discovered. In conclusion, we add three more patients with a simultaneous presentation of FFA and AA. It is recommended that clinicians use trichoscopy and obtain trichoscopy-guided biopsies (from broken hairs and hairs with peripilar casts) in cases with suspicious features. It is likely that a multifactorial etiology is involved in the development of both FFA and AA, but defining the shared genetic and/or environmental factors among the two diseases will facilitate further understanding of the pathogenesis and improve management.

show abstract

Section: Parameter (Mean) Cases (N = 18) Controls (N = 50) P Valuecontrasting

confidence: 57%

“…1,2 Dermoscopy has been shown to be useful to support the diagnosis of several inflammatory conditions, thus reducing the number of biopsies. [3][4][5][6][7] This might have a favorable impact in Figure 1 (a-d) Patients with exacerbation of disease following the first rituximab infusion…”

Section: A Retrospective Case-control Study Of Clinical Factors Assocmentioning

confidence: 99%

A retrospective case–control study of clinical factors associated with paradoxical exacerbation of pemphigus vulgaris following rituximab infusion

2020

View full text Add to dashboard Cite

show abstract

“…After depletion of CD20 + B cells by RTX, the role of T cells could prevail (Cummins et al., 2007). Exacerbation of pemphigus after RTX could be another evidence for the involvement of other immune cells in the pathogenesis of pemphigus (Nili et al., 2020). Besides, Dsg3‐specific CD4 + T cells were reported in cases with interface dermatitis (Takahashi et al., 2011).…”

Section: Figurementioning

confidence: 99%

Lichen planus‐like lesions in 36 patients with pemphigus: A cross‐sectional study

et al. 2020

Self Cite

View full text Add to dashboard Cite

“…3 Furthermore, rituximab may also cause depletion of regulatory B cells (Bregs), such as B10 cells, which also express CD20. 4 The imbalance between Bregs and pathogenic clones of B cells could induce worsening of PV. 4 Feldman suggested that a disturbance of the balance between Bregs and pathogenic clones of B cells could cause worsening of the disease.…”

mentioning

confidence: 99%

“…4 The imbalance between Bregs and pathogenic clones of B cells could induce worsening of PV. 4 Feldman suggested that a disturbance of the balance between Bregs and pathogenic clones of B cells could cause worsening of the disease. 5 It has also been hypothesized that specific anti-Dsg3 T cells may be involved in this process.…”

mentioning

confidence: 99%

Transient worsening of pemphigus vulgaris resembling toxic epidermal necrolysis after the first cycle of rituximab therapy

Mokos

Jukić

Marinović

2022

Dermatologic Therapy

View full text Add to dashboard Cite

spreading erythematous macules (that are not typical for PV) and flaccid blisters, TEN was suspected. Nevertheless, DIF and histology findings were consistent with PV. However, superinfection with Klebsiella pneumoniae prior to exacerbation in our patient fits with the results of a recent study showing that exacerbation of PV after rituximab was associated with more frequent secondary bacterial infections. 6 Further studies are needed to identify the factors that could predict this paradoxical reaction after rituximab treatment in PV patients. CONFLICT OF INTERESTThe authors declare that they have no conflict of interest. AUTHOR CONTRIBUTIONS Mislav Mokos: Analysis and interpretation of data, literature search, writing-original draft preparation, editing, final approval of the version to be published. Ines Lakoš Juki c: Analysis and interpretation of data, review and editing, final approval of the version to be published. Branka Marinovi c: Conceptualization, analysis and interpretation of data, literature search, review and editing, final approval of the version to be published. INFORMED CONSENTWritten informed consent was provided from the presented patient for the use of image and publication of the case details.

show abstract

Paradoxical reaction to rituximab in patients with pemphigus: a report of 10 cases

Cited by 23 publications

References 12 publications

A retrospective case–control study of clinical factors associated with paradoxical exacerbation of pemphigus vulgaris following rituximab infusion

A retrospective case–control study of clinical factors associated with paradoxical exacerbation of pemphigus vulgaris following rituximab infusion

Lichen planus‐like lesions in 36 patients with pemphigus: A cross‐sectional study

Transient worsening of pemphigus vulgaris resembling toxic epidermal necrolysis after the first cycle of rituximab therapy

Contact Info

Product

Resources

About