Rituximab as a first-line agent for the treatment of dermatomyositis.

Hdl Handle:
http://hdl.handle.net/10147/207983
Title:
Rituximab as a first-line agent for the treatment of dermatomyositis.
Affiliation:
Department of Rheumatology, Waterford Regional Hospital, Waterford, Republic of, Ireland, mharoon301@hotmail.com.
Citation:
Rheumatol Int. 2010 Mar 26.
Journal:
Rheumatology international
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207983
DOI:
10.1007/s00296-010-1458-6
PubMed ID:
20340018
Abstract:
B cells may play a pivotal role in the pathophysiology of DM, and reports have claimed that targeting B cells is a viable treatment option in patients with dermatomyositis. A 20-year-old girl presented in October 2007, with few weeks' history of proximal muscle weakness. Gottron's papules were noted on her knuckles. She had normal inflammatory markers and negative autoantibody screen. Her CPK was 7,000 U/L (normal range 0-170) with an LDH of 1,300 U/L (normal range 266-500). EMG and muscle biopsy was consistent with active myositis. She had normal pulmonary function tests. HRCT showed no interstitial lung disease. She was started with 60 mg glucocorticoids (1 mg/kg), with a good clinical response. However, any attempt to taper down the steroid dose led to recurrence of her symptoms. The options of available immunosuppressive therapies, including the experimental usage of rituximab, were discussed with her; averse to long-term systemic treatments, she opted to try a course of rituximab. She had rituximab 1,000 mg on days 0 and 14, and her glucocorticoids were tapered in next few weeks. Now, 24 months since her rituximab infusions, she remains in complete clinical and biochemical remission and is naive to other immunosuppressive agents apart from glucocorticoids and rituximab. Depleting peripheral B cells with rituximab (one course) in our patient has led not only to complete resolution of muscle and skin disease (induction) but also remains off all immunosuppressives including glucocorticoids.
Language:
ENG
ISSN:
1437-160X (Electronic); 0172-8172 (Linking)

Full metadata record

DC FieldValue Language
dc.date.accessioned2012-02-01T10:53:14Z-
dc.date.available2012-02-01T10:53:14Z-
dc.date.issued2012-02-01T10:53:14Z-
dc.identifier.citationRheumatol Int. 2010 Mar 26.en_GB
dc.identifier.issn1437-160X (Electronic)en_GB
dc.identifier.issn0172-8172 (Linking)en_GB
dc.identifier.pmid20340018en_GB
dc.identifier.doi10.1007/s00296-010-1458-6en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207983-
dc.description.abstractB cells may play a pivotal role in the pathophysiology of DM, and reports have claimed that targeting B cells is a viable treatment option in patients with dermatomyositis. A 20-year-old girl presented in October 2007, with few weeks' history of proximal muscle weakness. Gottron's papules were noted on her knuckles. She had normal inflammatory markers and negative autoantibody screen. Her CPK was 7,000 U/L (normal range 0-170) with an LDH of 1,300 U/L (normal range 266-500). EMG and muscle biopsy was consistent with active myositis. She had normal pulmonary function tests. HRCT showed no interstitial lung disease. She was started with 60 mg glucocorticoids (1 mg/kg), with a good clinical response. However, any attempt to taper down the steroid dose led to recurrence of her symptoms. The options of available immunosuppressive therapies, including the experimental usage of rituximab, were discussed with her; averse to long-term systemic treatments, she opted to try a course of rituximab. She had rituximab 1,000 mg on days 0 and 14, and her glucocorticoids were tapered in next few weeks. Now, 24 months since her rituximab infusions, she remains in complete clinical and biochemical remission and is naive to other immunosuppressive agents apart from glucocorticoids and rituximab. Depleting peripheral B cells with rituximab (one course) in our patient has led not only to complete resolution of muscle and skin disease (induction) but also remains off all immunosuppressives including glucocorticoids.en_GB
dc.language.isoENGen_GB
dc.titleRituximab as a first-line agent for the treatment of dermatomyositis.en_GB
dc.contributor.departmentDepartment of Rheumatology, Waterford Regional Hospital, Waterford, Republic of, Ireland, mharoon301@hotmail.com.en_GB
dc.identifier.journalRheumatology internationalen_GB
dc.description.provinceMunster-

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