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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.
- 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.
- Subjects :
- Aged
Antibodies, Monoclonal, Murine-Derived
Antigens, CD20 metabolism
B-Lymphocytes metabolism
Granulomatosis with Polyangiitis diagnostic imaging
Granulomatosis with Polyangiitis immunology
Granulomatosis with Polyangiitis metabolism
Humans
Immunohistochemistry
Lung diagnostic imaging
Lung metabolism
Lymphocyte Depletion
Male
Recurrence
Rituximab
Tomography, X-Ray Computed
Antibodies, Monoclonal therapeutic use
Granulomatosis with Polyangiitis drug therapy
Granulomatosis with Polyangiitis pathology
Immunologic Factors therapeutic use
Subjects
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