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Vasculitis rituximab

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https://www.readbyqxmd.com/read/28073870/successful-treatment-of-takayasu-arteritis-with-rituximab-as-a-first-line-immunosuppressant
#1
Mortimer B O'Connor, Neil O'Donovan, Ursula Bond, Mark J Phelan
Takayasu arteritis is a rare large vessel vasculitis which has traditionally been treated with high-dose steroids. There have been a small number of publications where biological agents have been used to manage refractory cases. To the authors knowledge, there are no publications using biological agents in combination with steroids as a first-line treatment in Takayasu arteritis. In this publication, we document the case of Takayasu arteritis, in a 39-year-old woman, where rituximab was used in combination with steroids as a first-line agent in the setting of poorly controlled bipolar affective disorder...
January 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28062909/paediatric-anti-neutrophil-cytoplasmic-antibody-anca-associated-vasculitis-an-update-on-renal-management
#2
REVIEW
Lucy A Plumb, Louise Oni, Stephen D Marks, Kjell Tullus
The anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are a group of disorders characterized by necrotizing inflammation of the small to medium vessels in association with autoantibodies against the cytoplasmic region of the neutrophil. Included in this definition are granulomatosis with polyangiitis (GPA, formerly known as Wegener's granulomatosis), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome). AAV are chronic, often relapsing diseases that can be organ or life threatening...
January 6, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28056474/-granulomatosis-with-polyangiitis
#3
Anja Kerstein, Konstanze Holl-Ulrich, Antje Müller, Gabriela Riemekasten, Peter Lamprecht
Granulomatosis with polyangiitis (GPA) is a potentially life-threatening, rare disease. The etiology is unknown. GPA is histomorphologically characterized by extravascular necrotizing granulomatous inflammation and a systemic necrotizing vasculitis of small to medium-sized vessels. Clinically, a pulmonary-renal syndrome with pulmonary infiltrates, alveolar hemorrhage and a rapidly progressive glomerulonephritis is seen in about 80% of the cases with generalized disease. GPA is associated with proteinase 3-specific anti-neutrophil cytoplasmic autoantibodies (PR3-ANCA)...
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28031844/refractory-rheumatoid-vasculitis
#4
Ashok Kumar, Anshul Goel, Mehul Lapsiwala, Suman Singhal
Systemic rheumatoid vasculitis (SRV) can develop in rheumatoid arthritis of long duration and high disease activity. It most commonly manifests as cutaneous vasculitis and mononeuritis multiplex. This can involve any organ of the body and carries very high mortality. We report a case of a young male who had rheumatoid arthritis for the past 15 years and became refractory to standard drugs and anti-TNF agents. He subsequently developed SRV, which started as mononeuritis multiplex. Disease progressed to result in gangrene of hands and feet despite receiving intravenous cyclophosphamide...
November 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28029751/the-effect-of-continuous-b-cell-depletion-with-rituximab-on-pathogenic-autoantibodies-and-total-igg-levels-in-anca-vasculitis
#5
Frank B Cortazar, William F Pendergraft, Julia Wenger, Charles T Owens, Karen Laliberte, John L Niles
OBJECTIVE: To evaluate the effect of rituximab on pathogenic autoantibodies and total immunoglobulin levels, and to identify serious adverse events, in patients with ANCA vasculitis treated with continuous B cell depletion. METHODS: We conducted a retrospective analysis of 239 patients with ANCA vasculitis treated with rituximab-induced continuous B cell depletion. Two treatment cohorts were analyzed: an induction group (n= 53) and a maintenance group (n=237). The change in ANCA titers and total immunoglobulin levels over time were evaluated using mixed-effects models...
December 28, 2016: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28012056/pachymeningitis-in-granulomatosis-with-polyangiitis-case-series-with-earlier-onset-in-younger-patients-and-literature-review
#6
Violeta Higuera-Ortiz, Abraham Reynoso, Natllely Ruiz, Rosa Delia Delgado-Hernández, Gilberto Gómez-Garza, Luis Felipe Flores-Suárez
The objective of this study is to describe the characteristics of patients with pachymeningitis (PM) in granulomatosis with polyangiitis (GPA) from Latin America, including three young patients. This is a retrospective case series. Patients were classified according to the ACR criteria, the 2012 Chapel Hill Consensus Conference Nomenclature and the EMA algorithm. Demographic, clinical, serological, and neuroimaging characteristics are described. Thirteen patients (nine females, four males) were identified. Mean age ± SD of PM diagnosis was 35...
December 23, 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27994990/refractory-case-of-takayasu-arteritis-in-a-young-woman-a-clinical-challenge
#7
Mudassar Ahmed, Salman Mansoor, Salman Assad, Shahar Y Khan, Rizwanullah Khan, Usman Ghani, Taimur Mansoor, Aasim Rehman
Takayasu arteritis (TA) is an idiopathic chronic inflammatory vasculitis of the aorta and its main branches, which if not treated can lead to severe vascular damage and fatal vascular events. Glucocorticoids (GCs) are the mainstay of the therapy of TA but a significant proportion of patients tend to experience flare-ups when their GCs are tapered. We report a case of a 42-year-old female with TA, diagnosed according to the 1990 American College of Rheumatology Criteria for TA. Cardiovascular assessment showed normal carotid upstrokes with bilateral carotid bruits and soft right and left subclavian bruits with weak peripheral pulses...
November 9, 2016: Curēus
https://www.readbyqxmd.com/read/27964796/vasculitis-and-inflammatory-arthritis
#8
REVIEW
Richard A Watts, David G I Scott
Vasculitis has been described in most types of inflammatory arthritis. The best described and most widely recognised form is rheumatoid vasculitis. The incidence of systemic rheumatoid vasculitis has declined significantly following the general early use of methotrexate in the 1990s, and it is now a rare form of vasculitis. Treatment of rheumatoid vasculitis is conventionally with glucocorticoids and cyclophosphamide, but there is an increasing role for rituximab similar to that in other types of vasculitis...
October 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27899372/effect-of-rituximab-on-malignancy-risk-in-patients-with-anca-associated-vasculitis
#9
Emma E van Daalen, Raffaella Rizzo, Andreas Kronbichler, Ron Wolterbeek, Jan A Bruijn, David R Jayne, Ingeborg M Bajema, Chinar Rahmattulla
OBJECTIVES: Patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) treated with cyclophosphamide have an increased malignancy risk compared with the general population. We investigated whether treatment with rituximab instead of cyclophosphamide has decreased the malignancy risk in patients with AAV. METHODS: The study included patients with AAV treated at a tertiary vasculitis referral centre between 2000 and 2014. The malignancy incidence in these patients was compared with the incidence in the general population by calculating standardised incidence ratios (SIRs), adjusted for sex, age and calendar year...
November 29, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27873751/rheumatoid-vasculitis-early-presentation-of-rheumatoid-arthritis
#10
Yasir Abdulqader, Muhsen Al-Ani, Konstantinos Parperis
Rheumatoid vasculitis is a rare and late complication of rheumatoid arthritis and may affect small-to-medium-sized vessels. Here, we report a case of a 49-year-old man who presented with amaurosis fugax in the left eye, symmetric polyarthritis, Raynaud's symptoms and paraesthesia in both lower extremities. The patient subsequently experienced right foot drop, nail fold infracts and gangrene of his right second toe. He was found to have a high titre of rheumatoid factor and treatment with rituximab and high dose of corticosteroids led to significant improvement of his symptoms...
November 8, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27872452/how-to-treat-anca%C3%A2-associated-vasculitis-practical-messages-from-2016-eular-era%C3%A2-edta-recommendations
#11
Jan Sznajd, Chetan Mukhtyar
The European League against Rheumatism (EULAR) with the European Renal Association - European Dialysis and Transplant Association recently published an update of 2009 EULAR recommendations with a focus on the management of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV). In this article, we discuss the following key messages for clinical practice derived from these recommendations: 1) biopsy should be performed if possible to confirm new diagnosis or relapse; 2) glucocorticoid therapy is an extremely important adjunct to the management of AAV, but it is also responsible for the majority of adverse effects; the dose should be tapered to 7...
October 28, 2016: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/27851530/1895-rituximab-therapy-in-refractory-diffuse-alveolar-hemorrhage-associated-with-anca-vasculitis
#12
Sahil Pandya, Mona Vashi, Robert Balk
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27813340/variation-in-treatment-of-children-hospitalized-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis-in-the-united-states
#13
Karen E James, Rui Xiao, Peter A Merkel, Pamela F Weiss
OBJECTIVE: There are few reports on treatment of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) in children. This study characterizes the use of cyclophosphamide, rituximab, and plasma exchange in children hospitalized with AAV in the United States. METHODS: We conducted a retrospective cohort study of children hospitalized with AAV from 2004-2014 utilizing an administrative and billing database from 47 tertiary care pediatric hospitals. All patients had an ICD-9-CM discharge code of 446...
November 3, 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/27791307/pediatric-cryoglobulinemic-vasculitis-successfully-managed-with-rituximab
#14
C Giménez-Roca, E Iglesias, M A Vicente, R Bou, J Calzada-Hernández, C Prat, M García, J Antón
No abstract text is available yet for this article.
October 28, 2016: Dermatologic Therapy
https://www.readbyqxmd.com/read/27780742/association-of-a-tnfsf13b-baff-regulatory-region-single-nucleotide-polymorphism-with-response-to-rituximab-in-anca-associated-vasculitis
#15
Federico Alberici, Rona M Smith, Mariana Fonseca, Lisa C Willcocks, Rachel B Jones, Julia U Holle, Stefan Wieczorek, Thomas Neumann, Davide Martorana, Gina Gregorini, Renato A Sinico, Annette Bruchfeld, Iva Gunnarsson, Sophie Ohlsson, Bo Baslund, Vladimir Tesar, Zdenka Hruskova, Maria C Cid, Augusto Vaglio, Paul A Lyons, Kenneth G C Smith, David R W Jayne
In ANCA-associated vasculitis (AAVs) response to rituximab is highly variable and predictors of response are needed. Our study identifies a single nucleotide polymorphism of the regulatory region of TNFSF13B (BAFF) associated with response to rituximab in AAV.
October 22, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27756269/acute-multifocal-hemorrhagic-retinal-vasculitis-in-a-child-a-case-report
#16
Malik Y Ghannam, Mohammed Naseemuddin, Peter Weiser, John O Mason
BACKGROUND: Acute Multifocal Hemorrhagic Retinal Vasculitis (AMHRV) is a rare disease with unknown incidence that presents with abrupt onset of visual loss associated with retinal vasculitis, retinal hemorrhage, non-confluent posterior retinal infiltrates, vitreous cellular inflammation and papillitis in, otherwise, healthy adult individuals. The reported treatment options for Acute Multifocal Hemorrhagic Retinal Vasculitis are oral corticosteroids, intravitreal ganciclovir and laser photocoagulation or vitrectomy...
October 18, 2016: BMC Ophthalmology
https://www.readbyqxmd.com/read/27744360/chronic-signs-of-memory-b-cell-activation-in-patients-with-beh%C3%A3-et-s-disease-are-partially-restored-by-anti-tumour-necrosis-factor-treatment
#17
Tim B van der Houwen, P Martin van Hagen, Wilhemina M C Timmermans, Sophinus J W Bartol, King H Lam, Jasper H Kappen, Menno C van Zelm, Jan A M van Laar
OBJECTIVES: Behçet's disease (BD), an auto-inflammatory vasculitis with oro-genital ulcerations, skin lesions and uveitis, is regarded as T cell mediated. A successful trial with rituximab suggests an additive role for B cells in the pathogenesis. Therefore, we studied B cell abnormalities in BD patients and the effect of TNF-blocking therapy. METHODS: B cells in blood (n = 36) and tissue (n = 6) of BD patients were analysed with flow cytometry and/or immunohistochemistry and compared with healthy controls (n = 22)...
January 2017: Rheumatology
https://www.readbyqxmd.com/read/27734231/the-significance-and-predictive-value-of-free-light-chains-in-the-urine-of-patients-with-chronic-inflammatory-rheumatic-disease
#18
Carsten Paul Bramlage, Britta Froelich, Manuel Wallbach, Joan Minguet, Clemens Grupp, Cornelia Deutsch, Peter Bramlage, Michael Koziolek, Gerhard Anton Müller
In patients with rheumatic diseases, reliable markers for determining disease activity are scarce. One potential parameter is the level of immunoglobulin free light chains (FLCs), which is known to be elevated in the blood of patients with certain rheumatic diseases. Few studies have quantified FLCs in urine, a convenient source of test sample, in patients with different rheumatic diseases. We carried out a retrospective analysis of patients with rheumatic disease attending the University hospital of Goettingen, Germany...
December 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/27733943/updates-in-anca-associated-vasculitis
#19
REVIEW
Christian Pagnoux
Antineutrophil cytoplasm antibody (ANCA)-associated vasculitides are small-vessel vasculitides that include granulomatosis with polyangiitis (formerly Wegener's granulomatosis), microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome). Renal-limited ANCA-associated vasculitides can be considered the fourth entity. Despite their rarity and still unknown cause(s), research pertaining to ANCA-associated vasculitides has been very active over the past decades. The pathogenic role of antimyeloperoxidase ANCA (MPO-ANCA) has been supported using several animal models, but that of antiproteinase 3 ANCA (PR3-ANCA) has not been as strongly demonstrated...
September 2016: European Journal of Rheumatology
https://www.readbyqxmd.com/read/27699052/induction-treatment-of-previously-undiagnosed-anca-associated-vasculitis-in-a-renal-transplant-patient-with-rituximab
#20
M P M Graham-Brown, R Aljayyousi, R J Baines, J O Burton, N J Brunskill, P Furness, P Topham
We report the case of a 40-year-old female transplant patient with undiagnosed ANCA-associated vasculitis (AAV) and renal allograft dysfunction who achieved disease remission with restoration of transplant function following induction therapy with rituximab. There are currently no trial data looking at the use of rituximab for induction of remission of renal transplant patients with AAV. Although recurrence of AAV following renal transplantation is rare, such patients have invariably had multiple previous exposures to induction and maintenance immunosuppressive regimens, often limiting treatment options post-transplantation...
October 2016: Oxford Medical Case Reports
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