Development of serum sickness-like symptoms after rituximab infusion in two patients with severe hypergammaglobulinemia.

Abstract

Rituximab is a monoclonal antibody that depletes B cells and is commonly used for the treatment of autoimmune diseases. In this report, we describe 2 patients with autoimmune diseases and marked hypergammaglobulinemia attending at a tertiary care hospital, who, following treatment with rituximab, developed a severe serum-sickness-like reactions. Both patients were treated with intravenous corticosteroids, recovered well, and on follow-up, were negative for the development of human antichimeric antibodies. Based on these and other similar cases in the literature, we propose that severe hypergammaglobulinemia due to autoimmune conditions may be a predisposing factor for the development of a serum sickness-like reaction after treatment with Rituximab, which can sometimes occur without prior exposure to this antibody. Rheumatologists should be aware of this possible association when prescribing this medication.

• Authors: Eduardo Finger, Morton Scheinberg
• Journal: Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases (J Clin Rheumatol) Vol. 13 Issue 2 Pg. 94-5 (Apr 2007) ISSN: 1076-1608 [Print] United States
• PMID: 17414540 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Murine-Derived
• Antirheumatic Agents
• Rituximab

Topics

• Adult
• Antibodies, Monoclonal (adverse effects)
• Antibodies, Monoclonal, Murine-Derived
• Antirheumatic Agents (adverse effects)
• Female
• Humans
• Hypergammaglobulinemia (drug therapy)
• Middle Aged
• Rituximab
• Serum Sickness (chemically induced)
• Treatment Outcome