Rituximab induces resolution of recurrent diffuse alveolar hemorrhage in a patient with primary antiphospholipid antibody syndrome

A. Scheiman Elazary, P. P. Klahr, A. Y. Hershko, Z. Dranitzki, A. Rubinow, Y. Naparstek

Research output: Contribution to journalArticlepeer-review

Abstract

Diffuse alveolar hemorrhage (DAH) is a rare manifestation of primary antiphospholipid antibody syndrome (APS). We describe a patient with primary APS and refractory recurrent episodes of DAH. The patient was admitted 15 times due to recurrent episodes of DAH in a period of 18 months. Multiple immunosuppressive drugs did not improve his condition. Two years after his presentation, he was treated with rituximab (two doses of 1 g, 2 weeks apart). Six months later, the attacks of DAH have gradually disappeared. In a follow-up of more than 2 years after he received rituximab, the patient has had no further admissions due to DAH. Levels of antiphospholipid antibodies were measured during follow-up of 4 years. Anti-β2 glycoprotein IgG titer decreased to normal 6 months after therapy but anticardiolipin (aCL) antibody titer increased. We conclude that rituximab caused a dramatic clinical response in this patient. Anti-β2 glycoprotein IgG correlated better with the clinical response in this patient than aCL.

Original languageEnglish
Pages (from-to)438-440
Number of pages3
JournalLupus
Volume21
Issue number4
DOIs
StatePublished - Apr 2012
Externally publishedYes

Keywords

  • alveolar
  • antiphospholipid
  • diffuse
  • hemorrhage
  • rituximab

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