Refractory antineutrophil cytoplasmic antibody-associated vasculitis successfully treated with rituximab: A case report

Yoshiro Horai, Tomoya Miyamura, Soichiro Takahama, Akie Hirata, Masataka Nakamura, Hitoshi Ando, Rumi Minami, Masahiro Yamamoto, Eiichi Suematsu

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

A 63-year-old-man was diagnosed in March 2002 with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis because of mononeuritis multiplex, interstitial pneumonia and a positive finding for myeloperoxidase (MPO)-ANCA. Although treated with prednisolone and oral cyclophosphamide, he suffered repeated remission and deterioration of his conditon, which was complicated by hypertrophic pachymeningitis and sinusitis. In July 2006, he was diagnosed with an exacerbation of ANCA-associated vasculitis because of pyrexia, general malaise, numbness in his face and legs, and elevated serum CRP level. Steroid pulse therapy was thus initiated and the patient's clinical symptoms improved. However, serum CRP levels elevated again (5.18 mg/dl) in September 2006.We began administration of rituximab (500 mg/body x 4 times) in November 2006 and his symptom and laboratory data signifficantly improved. The dose of prednisolone was slowly decreased without suffering a relapse. Rituximab has been administered every one year, and good disease control has been achieved. Diagnosis of Wegener's granulomatosis was made from the findings of a nodular lesion in the left lung. Rituximab should be considered for patients with refractory ANCA-associated vasculitis.

Original languageEnglish
Pages (from-to)105-110
Number of pages6
JournalJapanese Journal of Clinical Immunology
Volume33
Issue number2
DOIs
Publication statusPublished - 2010

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Immunology

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