Rituximab-Induced Coronary Vasospasm

Lee, Linda; Kukreti, Vishal

doi:10.1155/2012/984986

Cited by 12 publications

(10 citation statements)

References 15 publications

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“…This report represents the first case of CAV occurring in association with a temporal relationship to rituximab infusion after multiple prior uneventful exposures to rituximab. While CAV occurs most commonly due to 5-fluorouracil and capecitabine, adverse reactions to rituximab are extremely rare, with only one other case reported [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Coronary Vasospasm after Repeat Rituximab Infusion

Khosla

Davis

et al. 2015

Case Reports in Cardiology

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Coronary artery vasospasm (CAV) can be triggered by medication reactions. CAV occurring after multiple exposures to rituximab has not been previously described. A 61-year-old woman with no cardiac risk factors was treated with the sixth cycle of gemcitabine, cisplatin, dexamethasone, and rituximab therapy. Fifteen minutes after rituximab infusion commenced, she developed typical cardiac chest pain with ST segment elevations on electrocardiogram. Angiogram revealed evidence of coronary vasospasm. The patient was successfully treated with amlodipine. This case underlines the importance of monitoring cardiac side effects of rituximab therapy, even after multiple cycles.

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Section: Discussionmentioning

confidence: 99%

A Case of Coronary Vasospasm after Repeat Rituximab Infusion

Khosla

Davis

et al. 2015

Case Reports in Cardiology

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“…These findings in addition to reported cases of ACS/myocardial infarction associated with the infusion of rituximab ( Table 1 ) raise the concern of its cardiac side effect profile from rituximab since B-lymphocytes, particularly B1a-lymphocytes, were recently found to provide an atheroprotective effect ( 30 ). Besides, ACS due to coronary vasospasm following rituximab infusion was also reported ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Non-ischemic cardiomyopathy after rituximab treatment for membranous nephropathy

et al. 2016

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Rituximab is an anti-CD20 monoclonal antibody frequently used for the treatment of non-Hodgkin’s lymphoma, chronic lymphocytic leukemia (CLL), rheumatoid arthritis (RA), and anti-neutrophilic cytoplasmic antibody (ANCA)-associated vasculitis. In addition, rituximab has recently been increasingly used as an off-label treatment in a number of inflammatory and systemic autoimmune diseases. It is advised that rituximab infusion may cause infusion reactions and adverse cardiac effects including arrhythmia and angina, especially in patients with prior history of cardiovascular diseases. However, its detailed cardiotoxicity profile and effects on cardiac function were not well described. We report a 51-year-old man who developed non-ischemic cardiomyopathy after rituximab treatment for membranous nephropathy. The patient experienced reduced cardiac functions within 48 hours after the initial infusion, which remained markedly reduced at 9-month follow-up. As the utility of rituximab expands, physicians must be aware of this serious cardiovascular adverse effect.

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“…However, Lee and Kukreti20 in 2011 claimed that they reported the first case of coronary vasospasm following rituximab infusion. Their patient presented in a similar way to ours, with very similar ECG and angiogram findings, but an echocardiogram was not performed, or at the least not reported.…”

Section: Discussionmentioning

confidence: 99%

Rituximab-induced Takotsubo syndrome: more cardiotoxic than it appears?

Dearden

Gruber

2015

BMJ Case Reports

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Rituximab is used for treatment of multiple haematological cancers. Caution for use is advised in patients with significant cardiorespiratory disease due to known cases of exacerbations of angina and arrhythmias. However, its cardiotoxicity profile is not as well recognised as other monoclonal antibodies such as transtuzumab. We report a case of a 66-year-old man who developed Takotsubo's cardiomyopathy (TC) after an elective infusion of rituximab. This case is exceptional in that rituximab has not been linked to TC, and the vast majority of chemotherapy-linked and immunotherapy-linked TC reactions have occurred during initial infusions. We also discuss the different mechanisms which link TC to immunotherapy and chemotherapy, and propose that there may be a potential for risk-stratifying recipients of this frequently used immunotherapy prior to administering treatment.

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Rituximab-Induced Coronary Vasospasm

Cited by 12 publications

References 15 publications

A Case of Coronary Vasospasm after Repeat Rituximab Infusion

A Case of Coronary Vasospasm after Repeat Rituximab Infusion

Non-ischemic cardiomyopathy after rituximab treatment for membranous nephropathy

Rituximab-induced Takotsubo syndrome: more cardiotoxic than it appears?

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