Rituximab-Associated Inflammatory Progressive Multifocal Leukoencephalopathy

Punch, Chandra; Schofield, Christina; Harris, Penelope J

doi:10.1155/2016/8915047

Cited by 3 publications

(3 citation statements)

References 4 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For patients taking rituximab, the period of immunosuppression usually lasts six months to two years [23], but there are reports that B-cells have reappeared at 110 days, and it is unclear if a stimulus such as the one from a coronavirus infection like COVID-19 could trigger a more drastic and earlier response. Additionally, cases of early IRIS after rituximab therapy have also been reported, such as the case reported by Punch et al [24].…”

Section: Discussionmentioning

confidence: 87%

A Case of Steroid-Responsive Severe Pneumonia Following a Recent COVID-19 Infection in a Patient With Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection

Pourshahid

Khademolhosseini

Giri

et al. 2022

Cureus

View full text Add to dashboard Cite

A twenty-two-year-old woman with a history of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection (PANDAS) on rituximab presented with fever, abdominal pain, and worsening shortness of breath requiring supplemental oxygen via nasal cannula one month after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection from which she was minimally symptomatic and had recovered. Radiographic studies revealed bilateral patchy consolidations interspersed with ground-glass opacities (GGO). She was started on antibiotics for presumed community-acquired pneumonia with no improvement. Echocardiography revealed preserved biventricular function and a suspected intracardiac mass. A cardiac magnetic resonance imaging (CMRI) revealed myocarditis and no intracardiac mass. Fever persisted and oxygen requirements increased from FiO2 0.4 to 1.0. Repeat CXR showed subtotal left hemithorax opacification. Bronchoscopic samples showed a negative Gram stain and an unremarkable cell count differential. In view of this and given her lack of response to antibiotics with worsening respiratory status, high-dose steroids were started. She improved rapidly, and six days later she was off oxygen. Transbronchial biopsies showed benign parenchyma with some intra-alveolar fibrin deposition with no definitive evidence of viral cytopathic effect, vasculitis, or diffuse alveolar damage (DAD). Follow-up imaging in the pulmonary clinic revealed improvement of prior airspace disease with some new migratory opacities that completely resolved after 12 weeks. Pulmonary function tests and repeat CMRI were normal three months after discharge. Multisystem inflammatory syndrome in adults (MISA), postcovid organizing pneumonia (OP), and immune reconstitution inflammatory syndrome (IRIS) are rare and potentially steroid-responsive causes of pneumonia, which were in our differential diagnosis. It is imperative to consider the rare possibility of steroid-responsive pneumonia-like MISA, post-COVID-OP, and IRIS in patients with worsening respiratory symptoms following a recent SARS-CoV 2 infection.

show abstract

Section: Discussionmentioning

confidence: 87%

A Case of Steroid-Responsive Severe Pneumonia Following a Recent COVID-19 Infection in a Patient With Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infection

Pourshahid

Khademolhosseini

Giri

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…mAb acting against tumor antigen may cause fever, chills, respiratory complaints, and rashes. In rare cases, treatment with Rituximab (anti-CD20 mAb) may lead to progressive multifocal leukencephalopathy (PML) 128 . One typical side effect that may be caused by the anti-EGFR mAb Cetuximab is rashes, of which the etiology is still not completely clarified 129 .…”

Section: Chances and Risksmentioning

confidence: 99%

“…Gegen Tumorantigen-gerichtete mAb können Fieber, Schüttelfrost, Atembeschwerden und Hautausschläge verursachen. Unter der Behandlung von Rituximab (anti-CD20 mAb) kann in seltenen Fällen eine progressive multifokale Leukenzephalopathie (PML) auftreten 128 . Eine typische Nebenwirkung, die der anti-EGFR mAb Cetuximab hervorrufen kann, ist ein Hautausschlag, dessen Ätiologie immer noch nicht vollständig geklärt ist 129 .…”

Section: Chancen/ Risikenunclassified

Immuntherapie – Die neue Ära in der Onkologie

Kansy

Lang

2018

Laryngo-Rhino-Otol

View full text Add to dashboard Cite

ZuSammenfaSSungIn den letzten Jahren wurden bedeutende Fortschritte auf dem Gebiet der Immuntherapie erreicht mit teils langanhaltendem Therapieansprechen bei unterschiedlichsten Tumorentitäten. Die Basis hierfür bildet ein verbessertes Verständnis der Interaktion zwischen Tumor und Immunsystem und der damit verbundenen Integration immuntherapeutischer Ansätze in die klinische Routine. Die hierbei eingesetzten immuntherapeutischen Strategien greifen auf unterschiedlichen Ebenen der Immunantwort ein, för-dern direkt oder indirekt die Zerstörung der Tumorzellen durch die körpereigene Abwehr und reichen von Zytokintherapien über Vakzinierungen und den Einsatz onkolytischer Viren bis hin zu monoklonalen Antikörpertherapien und dem adoptiven Zelltransfer. aBStractIn the field of immunotherapy, essential progress was achieved over the past years partially demonstrating long lasting therapeutic responses in different tumor entities. A better understanding of the interactions between the tumor and the immune system as well as the integration of immunotherapeutic approaches into clinical routine were the foundations for this development. The different approaches intervene on multiple levels of the immune response and directly or indirectly mount the patient's own immune defense against tumor cells. Immunotherapeutic approaches are represented by cytokine therapies, vaccinations, the use of oncolytic viruses and monoclonal antibody therapies as well as adoptive cell transfer strategies.

show abstract