TY - JOUR
T1 - Refractory antineutrophil cytoplasmic antibody-associated vasculitis successfully treated with rituximab
T2 - A case report
AU - Horai, Yoshiro
AU - Miyamura, Tomoya
AU - Takahama, Soichiro
AU - Hirata, Akie
AU - Nakamura, Masataka
AU - Ando, Hitoshi
AU - Minami, Rumi
AU - Yamamoto, Masahiro
AU - Suematsu, Eiichi
N1 - Copyright:
Copyright 2015 Elsevier B.V., All rights reserved.
PY - 2010
Y1 - 2010
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=77953671528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77953671528&partnerID=8YFLogxK
U2 - 10.2177/jsci.33.105
DO - 10.2177/jsci.33.105
M3 - Article
C2 - 20453447
AN - SCOPUS:77953671528
VL - 33
SP - 105
EP - 110
JO - Immunological Medicine
JF - Immunological Medicine
SN - 0911-4300
IS - 2
ER -