Severe Wegener's granulomatosis successfully treated with rituximab


Cite item

Full Text

Abstract

The paper discusses the problems of the diagnosis and treatment of Wegener's granulomatosis, the most common anti-neutrophil cytoplasmic antibody-associated systemic vasculitis. It describes a clinical case in which the administration of rituximab could achieve remission of severe Wegener's granulomatosis in a young man having numerous adverse reactions associated with the long-term use of high- and average-dose glucocorticoids and nonselective immunosuppressive agents. A place of rituximab in current drug therapy for Wegener's granulomatosis is shown.

About the authors

E N Semenkova

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
Кафедра терапии и профболезнейд-р мед. наук, проф; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

O G Krivosheyev

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
Кафедра терапии и профболезней; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

P I Novikov

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: novikov-pavel@mail.ru
Кафедра терапии и профболезнейаспирант; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

V I Osipenko

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
канд. мед. наук, зав., отд-ние лучевой диагностики, клиника нефрологии, внутренних и профессиональных болезней им. Е. М. Тареева; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

N R Nosova

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
врач, клиника нефрологии, внутренних и профессиональных болезней им. Е. М. Тареева; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

S A Parfenova

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
врач, клиника нефрологии, внутренних и профессиональных болезней им. Е. М. Тареева; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

N V Nikiforova

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
зав., терапевтическое отд-ние, клиника нефрологии, внутренних и профессиональных болезней им. Е. М. Тареева; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

O O Borodin

I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

Email: tareevka@mtu-net.ru
ординатор, клиника нефрологии, внутренних и профессиональных болезней им. Е. М. Тареева; ГОУ ВПО ММА им. И. М. Сеченова Росздрава; I. M. Sechenov Moscow Medical Academy, Russian Agency for Health Care; E. M. Tareyev Clinic of Nephrology, Internal and Occupational Diseases

References

  1. Клименко С. В., Семенкова Е. Н., Кривошеев О. Г. Применение человеческого иммуноглобулина в комплексном лечении гранулематоза Вегенера. Лечащий врач 2005; 4: 23-28.
  2. Reff M. E., Carner K., Chambers K. S. et al. Depletion of B cells in vivo by a chimeric mouse human monoclonal antibody to CD20. Blood 1994; 83: 435-445.
  3. Arzoo K., Sadeghi S., Liebman H. A. Treatment of refractory antibody mediated autoimmune disorders with an anti-CD20 monoclonal antibody (rituximab). Ann. Rheum. Dis. 2002; 61: 922-924.
  4. Falk R. J., Jennette J. C. ANCA are pathogenic: oh yes they are! J. Am. Soc. Nephrol. 2002; 13: 1977-1979.
  5. Heeringa P., Tervaert J. W. Pathophysiology of ANCA-associated vasculitis: are ANCA really pathogenic? Kidney Int. 2004; 65: 1564-1567.
  6. Aouba A., Pagnoux C., Bienvenu B. et al. Analysis of Wegener's granulomatosis responses to rituximab: current evidence and therapeutic prospects. Clin. Rev. Allergy Immunol. 2008; 34: 65-73.
  7. Jayne D. R., Burns S., Smith K. B-cell depletion with rituximab for refractory vasculitis. Kidney Blood Press. Res. 2003; 26: 294.
  8. Jones R. B., Ferraro A. J., Chaudhry A. N. et al. A multicenter survey of rituximab therapy for refractory antineurotrophil cytoplasmic antibody-associated vasculitis. Arthr. and Rheum. 2009; 60: 2156-2168.
  9. Keogh K. A., Wylam M. E., Stone J. H. et al. Induction of remission by B lymphocyte depletion in eleven patients with refractory antineutrophil cytoplasmic antibody-associated vasculitis. Arthr. and Rheum. 2005; 52: 262-268.
  10. Lovric S., Erdbruegger U., Kümpers P. et al. Rituximab as rescue therapy in anti-neutrophil cytoplasmic antibody-associated vasculitis: a single-center experience with 15 patients. Nephrol. Dial. Transplant. 2009; 24: 179-185.
  11. Martinez Del Pero M., Chaudhry A., Jones R. B. et al. B-cell depletion with rituximab for refractory head and neck Wegener's granulomatosis: a cohort study. Clin. Otolaryngol. 2009; 34: 328-335.
  12. Eriksson P. Short-term outcome and safety in 5 patients with ANCA-positive vasculitis treated with rituximab. Kidney Blood Press. Res. 2003; 26: 294.
  13. Specks U., Fervenza F. C., McDonald T. J. et al. Response of Wegener's granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthr. and Rheum. 2001; 44: 2836-2840.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2010 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies