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Relapsed Wegener's granulomatosis after rituximab therapy--B cells are present in new pathological lesions despite persistent 'depletion' of peripheral blood.

Authors :
Ferraro AJ
Smith SW
Neil D
Savage CO
Source :
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [Nephrol Dial Transplant] 2008 Sep; Vol. 23 (9), pp. 3030-2. Date of Electronic Publication: 2008 Jun 27.
Publication Year :
2008

Abstract

Wegener's granulomatosis (WG) is a chronic, relapsing, systemic autoimmune disease. Rituximab, a monoclonal antibody against human CD20, has shown promise as a novel treatment for WG. The monitoring of therapeutic B-cell 'depletion' by peripheral blood flow cytometry has been proposed to help monitor rituximab therapy. We report the case of a patient with known WG and granulomatous disease, successfully treated with rituximab, who relapsed whilst peripheral blood monitoring apparently indicated persistent B-cell depletion. Further investigations demonstrated CD20(+) B cells in tissue at sites of active disease. The implications for disease pathogenesis and clinical monitoring of disease are discussed.

Details

Language :
English
ISSN :
1460-2385
Volume :
23
Issue :
9
Database :
MEDLINE
Journal :
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Publication Type :
Academic Journal
Accession number :
18586761
Full Text :
https://doi.org/10.1093/ndt/gfn318