Rituximab-induced neutropenia in a patient with inflammatory myopathy and systemic sclerosis overlap disease

Rituximab (RTX) is a monoclonal chimeric antibody directed against the CD20 antigen of B lymphocytes. Late onset neutropenia (LON) is a recognised complication of rituximab usually occurring 4 weeks after the last dose and is reported in both haematological and rheumatological conditions. However, it has never been described in a patient with myositis and systemic sclerosis overlap disease.We describe a case of LON in a 54-year-old man who was diagnosed with myositis and then systemic sclerosis overlap disease. It resolved within 7 days, and the patient did not suffer neutropenic sepsis or any other complications. We propose similar mechanisms for LON as described in other conditions and routine blood monitoring in such patients.

REFERENCJE (7)

Breuer G, Ehrenfeld M, Rosner I, et al. Late onset neutropenia following rituximab for rheumatic conditions. Clin Rheumatol 2014; 33: 1337-1340.

Google Scholar

Oddis CV, Reed AM, Aggarwal R, et al.; RIM Study Group. Rituximab in the Treatment of Refractory Adult and Juvenile Dermatomyositis and Adult Polymyositis A Randomized, Placebo-Phase Trial. Arthritis Rheum 2013; 65: 314-324.

Google Scholar

Rider LG, Giannini EH, Harris-Love M, et al.; International Myositis Assessment and Clinical Studies Group. Defining Clinical Improvement in Adult and Juvenile Myositis. J Rheumatol 2003; 30: 603-617.

Google Scholar

De Groot K, Muhler M, Reinhold-Keller E, et al. Randomised controlled trial of daily oral versus pulsed cyclophosphamide for induction of remission in ANCA associated systemic vasculitis (abstract). Kidney Blood Pressure Res 2005; 28: 195.

Google Scholar

Emery P, Rigby WF, Combe B, et al. Efficacy and safety of rituximab (RTX) as first-line biologic therapy in patients with active rheumatoid arthritis (RA): results of a phase III randomized controlled study (SERENE). Arthritis Rheum 2008; 58: S302.

Google Scholar

Besada E, Koldingsnes W, Nossent J. Characteristics of late onset neutropenia in rheumatology patients: a case review analysis from a single centre. QJ Med 2012; 105: 545-560.

Google Scholar

Tesfa D, Ajeganova S, Hagglund H, et al. Late onset neutropenia following rituximab therapy in rheumatic diseases: association with B lymphocyte depletion and infections. Arthritis Rheum 2011; 63: 2209-2214.

Google Scholar

Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Wyślij swój artykuł

Archiwum

Dla autorów

Udostępnij

Wyślij mailem

ARTYKUŁ POWIĄZANY

Cardiac involvement in idiopathic inflammatory myopathies

Shift in landscape of idiopathic inflammatory myopathies from before the COVID-19 pandemic and post-pandemic period – growing incidence of immune-mediated necrotizing myopathy

Rituximab in combination with mycophenolate mofetil in a patient with rapidly progressive systemic sclerosis and cyclophosphamide cardiotoxicity

Digital ischaemia associated with paraneoplastic systemic sclerosis

Biological therapies in the treatment of severe granulomatosis with polyangiitis

Indeksy