Rituximab inefficiency during type I cryoglobulinaemia

Nehme-Schuster, H.

doi:10.1093/rheumatology/keh503

Cited by 29 publications

(25 citation statements)

References 8 publications

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“…There have been similar reports in the literature of subclinical flares of autoimmune disease during rituximab treatment for pemphigus vulgaris 24 and type 1 cryoglobulinemia. 25 In our patients, it could be interpreted that rituximab may have caused a subclinical flare in DM before the beneficial effect is observed. Further side effects from rituximab include infusion reactions, which resolve from reduction of the infusion rate.…”

Section: Discussionmentioning

confidence: 64%

Rituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases

Dinh

McCormack

Hall

et al. 2007

Journal of the American Academy of Dermatology

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Section: Discussionmentioning

confidence: 64%

Rituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases

Dinh

McCormack

Hall

et al. 2007

Journal of the American Academy of Dermatology

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“…They reported that patient's neuropathy and skin lesions was improved 8 months after treatment. On the other hand, a lack of efficacy of rituximab was reported by Nehme-Schuster et al [5] in two patients with type I-CG, and by Cohen et al [6] in a patient with EMC. In contrast, in this present study we showed the efficacy of rituximab in a 21-year-old female patient suffered from EMC.…”

Section: Discussionmentioning

confidence: 92%

A case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab

Paşa

Altıntaş

Çil

et al. 2008

J Thromb Thrombolysis

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Current treatment options of essential mixed cryoglobulinemia (EMC); include immunosuppressive approaches, such as corticosteroids, cyclophosphamide, plasma exchange, other cytotoxic drugs in moderate to severe manifestations. Some controlled studies have been carried out to assess the efficacy of anti-CD20 monoclonal antibody, rituximab in patients with hepatitis C (HCV) related cryoglobulinemia (CG) and in patients with autoimmune disorders. Recent trials and some case reports demonstrate a beneficial role for rituximab in HCV related mixed CG. Although, the published evidence for treatment of EMC with rituximab is restricted to case reports, which have shown positive results. Several diseases include lymphoproliferative and myeloproliferative disorders, solid tumors, immunological disorders, cardiovascular disorders and some drugs associated with acquired von Willebrand disease (avWD). CG, which is a kind of immune complex disease, may be related with development of autoantibodies to various autoantigens. In this present case report, we showed the efficacy of rituximab in a 21-year-old female patient, suffered from neuropathy and arthralgia related with EMC, and developed avWD, presented with mucosal bleeding associated with CG. von Willebrand factor activity of our patient also increased with controlling the underlying disease, EMC by rituximab. This case demonstrate that rituximab may be an effective treatment option in EMC and avWD mainly related to CG.

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“…Rosenthal et al reported a patient with polyneuropathy and vasculitis associated with a type I cryoglobulin whose evolution was controlled by rituximab. However, two cases with type I cryoglobulinemia resistant to rituximab were recently reported [16].…”

Section: Discussionmentioning

confidence: 99%

Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenström’s macroglobulinemia

et al. 2008

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Waldenström's macroglobulinemia is rare lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraproteinemia. Cryoglobulinemia is a common sequela of Waldenström's macroglobulinemia present in 8-18% of the patients. Cryoglobulinemia has also been described as occurring after treatment with rituximab. In the previous report, the cryoglobulinemia was a transient phenomenon and did not carry any adverse effect. We present a case of an 80-year-old male with Waldenström's macroglobulinemia in whom the rituximab-induced cryoglobulinemia resulted in acute renal failure and a vasculitic rash. Cryoglobulins level reached a peak of 63%. The patient was successfully treated with plasmapheresis, chlorambucil and prednisone, with near-complete recovery of renal function. As this case illustrates, the rituximab-induced cryoglobulin is not always benign. Pre- and post-treatment monitoring of the cryoglobulin level is advised in these patients.

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Rituximab inefficiency during type I cryoglobulinaemia

Cited by 29 publications

References 8 publications

Rituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases

Rituximab for the treatment of the skin manifestations of dermatomyositis: A report of 3 cases

A case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab

Acute renal failure secondary to severe type I cryoglobulinemia following rituximab therapy for Waldenström’s macroglobulinemia

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