Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Two Cases of Refractory Wegeners Granulomatosis Successfully Treated with Rituximab
Naoto Tamura, Ran Matsudaira, Mika Hirashima, Makoto Ikeda, Michiko Tajima, Masuyuki Nawata, Shinji Morimoto, Kazuhiko Kaneda, Shigeto Kobayashi, Hiroshi Hashimoto, Yoshinari Takasaki
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Keywords: Wegeners granulomatosis, anti-neutrophil cytoplasmic antibody (ANCA), rituximab, therapy, capture ELISA
JOURNAL OPEN ACCESS

2007 Volume 46 Issue 7 Pages 409-414

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Abstract

Conventional therapy for Wegeners granulomatosis, steroid and cyclophosphamide, fails to control disease activity in some refractory patients and has treatment-related toxicity. B cell depletion therapy using rituximab, a chimeric anti-CD20 monoclonal antibody, has been shown to be effective for certain autoimmune diseases including antineutrophil cytoplasmic antibody (ANCA) -associated systemic vasculitis. We report two refractory cases of Wegeners granulomatosis: one with bronchial and pulmonary involvement and retroorbital granuloma, the other with retroorbital granuloma and hypertrophic pachymeningitis causing severe headache. Rituximab was effective in both cases, with diminished granuloma and reduced ANCA titers, allowing steroids to be tapered. No adverse effects were detected.

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© 2007 by The Japanese Society of Internal Medicine
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