Combination treatment with rituximab and belimumab in shrinking lung syndrome in systemic lupus erythematosus

Abstract

We report the case of a Caucasian, non-smoker, 66-year-old female with systemic lupus erythematosus (SLE) for over 20 years, with cumulative mucocutaneous, articular, hematologic, serosal, and serologic involvement. Due to persistent polyarthritis and recurrent episodes of pleural effusion despite maintenance treatment with prednisolone 10 mg/day, hydroxychloroquine 400 mg/day, and subcutaneous methotrexate 25 mg/week, intravenous belimumab 10 mg/kg was initiated as add-on therapy in July 2020, allowing