From: Rituximab for the treatment of refractory pediatric autoimmune diseases: a case series
Patient/Gender | Diagnosis | Age at Disease Onset [years] | Disease Symptoms | Disease Duration before Treatment [years] | Medication before Rituximab treatment | Rituximab Indication | Rituximab Dosis [mg/m]2 | Rituximab Courses [4 doses/course] | Time to Return of peripheral B-cells3 | Time to Relapse | AE/SAE | Follow-up Time [years] |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1. female | JDM | 14 | heliotropic rash Gottron's patcnes muscul. weakness contractures difficult breathing difficult swallowing diffjcult speach | 1 | MP(10 pulses) P MTX IVIG (10 pulses) CSA | progressive disease despite therapy | 375 | 2 | *11 months **progress without B-cells | *3 months **3 months | none/none | 2 |
2. male | WG | 10 | episcleritis arthralgia cough skin ulcers fever weight loss | 1 | MP (2 pulses) CYC (6 pulses) P MTX AZA | relapsing disease despite therapy | 375 | 1 | 5 months | no relapse | none/none | 2 |
3. male | SLE | 7 | malar rash glomerulonephrilis CNS vasculitis | 2 | AZA MP (? pulses) CYC plasmapheresis | severe CNS involvement | 375 | 1 single dose | no data | no relapse | none/none | 6 |
4. female | SLE WG | 13 for SLE 14 for MG | thrombosis (DVTJ fever sweating fatigue weight loss malar rash loss of strength diplopic images | 4 | P, AZA CYC (6 pulses) MP (6 pulses) MMF Pyridostigmine plasmapheresis1 NSAlDs | *relapsing MG despite therapy **disease flare before ASCT ***disease flare after ASCT | 375 | 3 | *6 months **no B-ceii retum[dis.flare without B-cells) ***2 months | *response clinically insignificant **no response followed by ASCT ***no relapse | mild bronchitis/none | 1.5 |
5. female | MS SLE | 3 for MS 17 for SLE | opticus neuritis hemiparesis malar rash arthritis | 1.5 | MP (multiple pulses) intraocular Steroids CYC (12 pulses) (β-lnterferon AZA MMF NSAlDs | *relapsing/progressive SLE nephritis despite therapy **autoimmune anemia/thrombo cytopenia after ASCT | 375 | 2 2 single doses | *12 months (including time after ASCT) **no B-cell depletion after 2 single doses | *partial to nituximab but development of glomerulonephritis **partial response, repeatedly low erythrocyties/thrombocytes | none/none patient's death due to Evans syndrome/disease recurrence | 1 |