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Rituximab-Related Late-Onset Neutropenia in Patients with Rheumatic Diseases: Successful Re-Challenge of the Treatment

Tatiana Reitblat, Alexander Wechsler, Olga Reitblat

(Department of Rheumatology, Barsilai Medical Center, Ashkelon, Israel)

Am J Case Rep 2015; 16:211-214

DOI: 10.12659/AJCR.892541

Background: We describe here 2 patients who developed late-onset neutropenia after Rituximab treatment.
While this phenomenon is well described among patients suffering from hematological malignancies, such adverse effects are rare among patients with rheumatic diseases.
Case Report: Two patients, the first with rheumatoid arthritis and the second with granulomatosis with polyangiitis, were treated by Rituximab after all previous treatments failed. The patients developed late-onset neutropenia after several courses of treatment. The first patient, with symptomatic neutropenia, recovered after a single dose of granulocyte macrophage stimulating factor, and the second patient’s neutrophils increased spontaneously.
Both patients were retreated by rituximab in their scheduled time without further complications.
Conclusions: Our case series is unique because the same phenomenon appeared in patients with different rheumatic diseases. This case series confirms the possibility of continuing the treatment without further adverse effects.

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