The limited role and risky profile of Rituximab in nephritis associated with Henoch-Schönlein purpura
Adult-onset IgA vasculitis or Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by IgA1-dominant deposits. The symptoms include cutaneous purpura, ankle arthritis, enteritis and nephritis. HSP nephritis (HSPN) can be severe and refractory to corticosteroids with/without immunosuppressive agents. The concept of depletion of antibody producing B cell with Rituximab is appealing despite the uncertainity of HSP pathogenesis. In the present case report; we describe our experience with Rituximab treatment in a patient with this disease. Our patient had different triggering factors for her relapses and lately Rituximab itself. Review of the literature indicates that autoantibodies to Gd-IgA1 did not decrease with Rituximab therapy and others indicated an inherited predisposition for higher levels in patients with progressive disease. Our findings confirm the limited role and risky profile of Rituximab in treatment of HSP.
Keywords: HSP, IgA, Rituximab, vasculitis.
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