Document Detail

Therapeutic effectiveness of rituximab in a patient with unresponsive autoimmune pulmonary alveolar proteinosis.
MedLine Citation:
PMID:  20855439     Owner:  NLM     Status:  MEDLINE    
Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterised by the accumulation of lung surfactant in the alveoli. In most cases it is an autoimmune disease with antibodies directed against the growth factor granulocyte-macrophage colony stimulating factor (GM-CSF). Standard of care consists of whole lung lavages in symptomatic patients. An alternative treatment is GM-CSF injections. The case history is reported of a patient with PAP and severe dyspnoea and hypoxaemia. Whole lung lavages and GM-CSF initially resulted in partial remission. However, the patient's condition deteriorated and her saturation during rest with high-flow oxygen treatment was 85%. The patient was treated with an anti-CD20 antibody rituximab which resulted in dramatic improvement. Room air saturation increased to 98% with exercise and she no longer required supplemental oxygen. The diffusion capacity for carbon monoxide increased from 27% to 48% of predicted and the chest x-rays improved. Rituximab may be useful in the treatment of patients with unresponsive PAP.
Anat Amital; Shlomo Dux; David Shitrit; Ofer Shpilberg; Mordechai R Kramer
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-09-20
Journal Detail:
Title:  Thorax     Volume:  65     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-22     Completed Date:  2010-11-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  1025-6     Citation Subset:  IM    
Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petah Tiqwa 49100, Israel.
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MeSH Terms
Antibodies, Monoclonal, Murine-Derived / therapeutic use*
Antigens, CD20 / immunology
Autoimmune Diseases / drug therapy*,  physiopathology
Immunosuppressive Agents / therapeutic use*
Pulmonary Alveolar Proteinosis / drug therapy*,  physiopathology
Reg. No./Substance:
0/Antibodies, Monoclonal, Murine-Derived; 0/Antigens, CD20; 0/Immunosuppressive Agents; 0/rituximab

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