Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis.
Carolin SchwakeRalf GoldPublished in: Neurological research and practice (2020)
Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in the specific context of MS. We present the case of a 45-year-old male patient who developed severe pneumonia following 6 years of rituximab treatment for highly active relapsing-remitting MS. The patient had no additional chronic disease as well as no history of foreign travel. Although the unusual formation of a pulmonary cavity raised suspicion for tuberculosis, repeated testing via bronchoscopy and sputum remained negative. Prolonged antibiotic therapy with piperacillin/tazobactam and amoxicillin/ clavulanate led to complete recovery from symptoms. This case shows the potential risk of serious infections following continuous B-cell depletion in MS and illustrates the importance of future vigilance.
Keyphrases
- multiple sclerosis
- white matter
- pulmonary hypertension
- mass spectrometry
- diffuse large b cell lymphoma
- case report
- early onset
- emergency department
- ms ms
- pulmonary tuberculosis
- stem cells
- human health
- combination therapy
- chronic lymphocytic leukemia
- current status
- hiv aids
- rheumatoid arthritis
- replacement therapy
- drug induced
- depressive symptoms
- hepatitis c virus
- acute respiratory distress syndrome
- multidrug resistant