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Rituximab administration in a patient with pemphigus vulgaris following reactivation of occult hepatitis B virus infection.
- Source :
-
Dermatology online journal [Dermatol Online J] 2017 Jun 20; Vol. 23 (6). Date of Electronic Publication: 2017 Jun 20. - Publication Year :
- 2017
-
Abstract
- Immunosuppressive drugs are the milestone of treatment of autoimmune diseases, but they can lead to serious complications, including hepatitis B virus reactivation in HBV carriers as well as in patients with occult HBV infection (OBI). A 36-year-old man with OBI was diagnosed with pemphigus vulgaris. He was prescribed prednisolone and his hepatitis B surface antigen turned positive. Viral replication was successfully controlled by lamivudine and adefovir. Mycophenolate mofetil and intravenous immunoglobulin  were not effective in controlling the pemphigus vulgaris. The patient received rituximab 500 mg weekly for four weeks and went into remission without any adverse effect. He safely received another course of rituximab after a relapse one year later. In conclusion, testing for hepatitis B core antibody should be considered mandatory, in addition to HBsAg, for the screening of pemphigus patients to detect rare cases of OBI before starting therapy. Furthermore, rituximab may in some cases be safely used in HBV carriers using antivirals concomitantly.
- Subjects :
- Adult
Antigens, CD20 immunology
Antiviral Agents therapeutic use
Drug Therapy, Combination
Glucocorticoids therapeutic use
Hepatitis B drug therapy
Hepatitis B Surface Antigens blood
Humans
Immunocompromised Host
Immunologic Factors adverse effects
Male
Prednisolone therapeutic use
Recurrence
Remission Induction
Glucocorticoids adverse effects
Hepatitis B etiology
Immunologic Factors therapeutic use
Pemphigus drug therapy
Prednisolone adverse effects
Rituximab therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1087-2108
- Volume :
- 23
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Dermatology online journal
- Publication Type :
- Academic Journal
- Accession number :
- 28633752