Document Detail


Proinflammatory syndrome mimicking acute rheumatoid arthritis in a patient with Waldenstrom's macroglobulinemia treated with rituximab.
MedLine Citation:
PMID:  14513285     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Acute adverse reactions to rituximab treatment have been previously described in association with initiation of therapy. We describe a novel delayed proinflammatory syndrome which occurred at, or near, the completion of a 4-week dose-intense course with rituximab in a 58-year-old man with Waldenstrom's macroglobulinemia, and which mimicked acute rheumatoid arthritis affecting the hands and the knees. This syndrome was associated with an increase in acute phase reactants, and the clinical symptoms were temporally reproducible, although decreased in severity, with subsequent rituximab therapy, and each time responded to prednisone. This is the first report on an acute rheumatoid-like flare occurring in association with rituximab therapy. This phenomenon is all the more intriguing in that rituximab has been used to treat refractory rheumatoid arthritis. Potential etiologic mechanisms and management of this newly described phenomenon are discussed.
Authors:
E M Buda-Okreglak; J J Drabick; N R Delaney
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2003-09-25
Journal Detail:
Title:  Annals of hematology     Volume:  83     ISSN:  0939-5555     ISO Abbreviation:  Ann. Hematol.     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-01-14     Completed Date:  2004-03-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9107334     Medline TA:  Ann Hematol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  117-9     Citation Subset:  IM    
Affiliation:
Hematology/Oncology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. Edwarda.Buda-Okreglak@na.amedd.army.mil
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Antinuclear / blood
Antibodies, Monoclonal / adverse effects*,  therapeutic use
Antineoplastic Agents / adverse effects,  therapeutic use
Arthritis, Rheumatoid / chemically induced,  diagnosis*
C-Reactive Protein / analysis
Diagnosis, Differential
Humans
Inflammation / blood,  chemically induced,  diagnosis*
Leukocytes
Male
Middle Aged
Rheumatoid Factor / blood
Syndrome
Waldenstrom Macroglobulinemia / blood,  drug therapy*
Chemical
Reg. No./Substance:
0/Antibodies, Antinuclear; 0/Antibodies, Monoclonal; 0/Antineoplastic Agents; 0/rituximab; 9007-41-4/C-Reactive Protein; 9009-79-4/Rheumatoid Factor

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