Document Detail


Refractory antineutrophil cytoplasmic antibody-associated vasculitis successfully treated with rituximab: a case report.
MedLine Citation:
PMID:  20453447     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 63-year-old-man was diagnosed in March 2002 with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis because of mononeuritis multiplex, interstitial pneumonia and a positive finding for myeloperoxidase (MPO)-ANCA. Although treated with prednisolone and oral cyclophosphamide, he suffered repeated remission and deterioration of his conditon, which was complicated by hypertrophic pachymeningitis and sinusitis. In July 2006, he was diagnosed with an exacerbation of ANCA-associated vasculitis because of pyrexia, general malaise, numbness in his face and legs, and elevated serum CRP level. Steroid pulse therapy was thus initiated and the patient's clinical symptoms improved. However, serum CRP levels elevated again (5.18 mg/dl) in September 2006. We began administration of rituximab (500 mg/bodyx4 times) in November 2006 and his symptom and laboratory data significantly improved. The dose of prednisolone was slowly decreased without suffering a relapse. Rituximab has been administered every one year, and good disease control has been achieved. Diagnosis of Wegener's granulomatosis was made from the findings of a nodular lesion in the left lung. Rituximab should be considered for patients with refractory ANCA-associated vasculitis.
Authors:
Yoshiro Horai; Tomoya Miyamura; Soichiro Takahama; Akie Hirata; Masataka Nakamura; Hitoshi Ando; Rumi Minami; Masahiro Yamamoto; Eiichi Suematsu
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Nihon Rinshō Men'eki Gakkai kaishi = Japanese journal of clinical immunology     Volume:  33     ISSN:  1349-7413     ISO Abbreviation:  Nihon Rinsho Meneki Gakkai Kaishi     Publication Date:  2010  
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505992     Medline TA:  Nihon Rinsho Meneki Gakkai Kaishi     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  105-10     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Rheumatology, Clinical Research Center, National Hospital Organization, Kyushu Medical Center.
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MeSH Terms
Descriptor/Qualifier:
Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis
Antibodies, Antineutrophil Cytoplasmic / blood
Antibodies, Monoclonal / administration & dosage*
Biological Markers / blood
C-Reactive Protein
Cyclophosphamide / administration & dosage
Drug Therapy, Combination
Humans
Male
Middle Aged
Prednisolone / administration & dosage
Recurrence
Treatment Outcome
Wegener Granulomatosis / diagnosis*,  drug therapy*
Chemical
Reg. No./Substance:
0/Antibodies, Antineutrophil Cytoplasmic; 0/Antibodies, Monoclonal; 0/Biological Markers; 0/rituximab; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 9007-41-4/C-Reactive Protein

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