Source: Surgery  |  Posted 9 years ago

Rituximab may be effective treatment for patients with refractory antibody mediated autoimmune disorders or for those who cannot tolerate corticosteroid or cytotoxic therapy.

Because of its novel mechanism of action, rituximab, a chimeric monoclonal anti-CD20 antibody, has been considered for treating refractory antibody mediated autoimmune diseases, such as immune mediated thrombocytopenia and haemolytic anaemia.

Karo Arzoo and colleagues at University of Southern California's Keck School of Medicine, in Los Angeles, United States, treated three such patients with rituximab.

The first patient was a 71 year old woman with refractory idiopathic type II mixed essential cryoglobulinaemia. The patient had both dermatological and neurological manifestations, with marked renal disease attributed to the disorder.

The second patient was a 73 year old woman with Goodpasture's syndrome, who failed to respond to cyclophosphamide, prednisone or plasmapheresis. She had persistent haemoptysis and haematuria and positive antiglomerular basement membrane antibodies, the researchers reported.

The third patient, a 75 year old man with primary biliary cirrhosis, myelodysplasia, and systemic immune complex vasculitis, had progressive renal insufficiency, a macular erythematous rash, and severe thrombocytopenia.

All clinical and laboratory manifestations of the disorders in each of the patients resolved following treatment with rituximab, the investigators reported.

"Rituximab may be an important therapeutic agent for the treatment of patients refractory or intolerant to corticosteroid or cytotoxic treatment, or both," they concluded.