Document Detail


Rituximab-induced lung disease: A systematic literature review.
MedLine Citation:
PMID:  19608586     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The anti-CD20 antibody rituximab has been reported to induce a heterogeneous spectrum of lung disorders. The aim of the present study was to critically review data on the clinical presentations, causality assessments and management strategies of lung diseases possibly related to rituximab. A systematic literature review was performed on English-language reports in PubMed until September 2008. Cases of lung diseases ascribed to rituximab (n = 45) were identified, with three time-to-onset patterns. The most common presentation was acute/subacute hypoxaemic organising pneumonia (n = 37), starting 2 weeks after the last infusion (often around the fourth cycle) and resolving, in most cases, provided glucocorticoid therapy was given early. Acute respiratory distress syndrome occurred in five patients, within a few hours and usually after the first infusion. In the remaining three patients, macronodular organising pneumonia developed insidiously long after rituximab therapy and responded to steroids. Eight patients died. Based on time to onset, symptoms, and responses to discontinuation and rechallenge with rituximab and other drugs, 13 cases were highly compatible and 32 compatible with rituximab-induced lung disease. Knowledge of these presentations of rituximab-induced lung disease should prove helpful for diagnosis and causality assessment purposes. Time-to-onset data, suggesting different pathogenic mechanisms, support closer clinical and perhaps radiological monitoring between infusions, particularly in patients with a history of reversible respiratory symptoms.
Authors:
H Lioté; F Lioté; B Séroussi; C Mayaud; J Cadranel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-07-16
Journal Detail:
Title:  The European respiratory journal     Volume:  35     ISSN:  1399-3003     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-01     Completed Date:  2010-06-24     Revised Date:  2013-05-23    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  681-7     Citation Subset:  IM    
Affiliation:
Centre de compétence maladies pulmonaires rares, Hôpital -Tenon, Paris, France. huguette.liote@tnn.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antibodies, Monoclonal / adverse effects*
Antibodies, Monoclonal, Murine-Derived
Biological Factors / adverse effects*
Drug Hypersensitivity / physiopathology
Female
Humans
Lung Diseases, Interstitial / chemically induced*
Male
Middle Aged
Respiratory Distress Syndrome, Adult / chemically induced
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Murine-Derived; 0/Biological Factors; 0/rituximab

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