Anti-CD20 monoclonal antibody (rituximab) as an adjunct in the treatment of giant cell arteritis
- A Bhatia1,
- P J Ell2,
- J C W Edwards1
- 1Department of Rheumatology, University College London Hospitals, Arthur Stanley House, 40-50 Tottenham Street, London W1T 4NJ, UK
- 2Institute of Nuclear Medicine, University College London Hospitals, Middlesex Hospital, Mortimer Street, London W1T 3AA, UK
- Correspondence to:
Professor J C W Edwards
jo.edwardsucl.ac.uk
- Accepted 18 April 2005
We describe a patient with polymyalgia rheumatica/giant cell arteritis (PMR/GCA) whose disease was refractory to a reduction in the dose of her glucocorticoid to an acceptable level. Our patient improved after B lymphocyte depletion but developed respiratory problems. To our knowledge this is the first description of such a case.
CASE REPORT
An 82 year old woman presented with a 4 week history of symptoms consistent with GCA of the temporal arteries and PMR. Of significance in her past medical history she had significant chronic airflow limitation with an FEV1/FVC (forced expiratory volume in 1 second/forced vital capacity) of 0.7/1.2. Computed tomography of her chest identified a small area of bronchiectasis in the left lower lobe of her chest.
Her erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were, 109 mm/1st h (normal 1–20) and 230 mg/l (normal 0–5.0), respectively. Treatment was started with 50 mg of prednisolone. Three weeks later …
