Objectives Rituximab is a monoclonal antibody drug used in malignancies and autoimmune diseases. Rituximab used for improving the symptoms and preventing rheumatic disease. We examined the effects of rituximab treatment on the cerebral blood flow velocity with transcranial Doppler ultrasonography (TCD) in rheumatic patients.
Methods 20-65 aged 7 patients (2 patients with secondary interstitial lung involvement to rheumatoid arthritis, 3 patients with systemic lupus erythematosus and lupus nephritis, 2 patients with scleroderma and secondary interstitial lung disease) who receive rituximab treatment due to rheumatic diseases were included the study. Patients were evaluated before rituximab treatment and after 6 months. Values of bilateral middle cerebral artery (MCA) peak-systolic,end-diastolic and mean blood flow velocity, Gosling pulsatility index values and Pourcelot resistance index value were recorded with TCD by a neurosonologist blinded to patients. The obtained values were compared with each other.
Results 1 patient was male and 6 patients were female. The mean age was found 52.3±4.7. TCD values were compared before and after treatment with rituximab. After treatment the peak-systolic, end-diastolic and mean blood flow velocity were significantly lower.
Conclusions Inflammation has an important role in the pathogenesis and prognosis of atherosclerosis. In these patients, particularly IL-6, TNF-alpha and CRP as inflammatory markers are found in high levels. Significantly increased cerebral blood flow velocity can be caused by atherosclerosis mechanism in this patients before treatment. In the sixth month After Rituximab treatment, decreasing high blood flow velocity was thought to be due to subdued inflammation.
Disclosure of Interest None declared