A Case of Rituximab Therapy in Diffuse Alveolar Hemorrhage of Systemic Lupus Erythematosus Refractory to Steroid Pulse Therapy

Sang Woo Yim; Chang Kyoo Byon; Jun Yong Park; Sang Yeob Lee; Sung Won Lee; Won Tae Chung

doi:10.4078/jrd.2014.21.4.201

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Yim, Byon, Park, Lee, Lee, and Chung: A Case of Rituximab Therapy in Diffuse Alveolar Hemorrhage of Systemic Lupus Erythematosus Refractory to Steroid Pulse Therapy

Case Report

J Rheum Dis 2014;21(4):201-204.

Published online: 31 October 2014

DOI: https://doi.org/10.4078/jrd.2014.21.4.201

A Case of Rituximab Therapy in Diffuse Alveolar Hemorrhage of Systemic Lupus Erythematosus Refractory to Steroid Pulse Therapy

Sang Woo Yim, Chang Kyoo Byon, Jun Yong Park, Sang Yeob Lee, Sung Won Lee, Won Tae Chung

Division of Rheumatology, Department of Internal Medicine, Dong-A University Hospital, Busan, Korea

Corresponding to: Won Tae Chung, Division of Rheumatology, Department of Internal Medicine, Dong-A University Hospital, 1, Dongdaeshin-dong 3 ga, Seo-gu, Busan 602-715, Korea. E-mail: wtchung@dau.ac.kr

Received 1 July 2013 Revised 20 September 2013 Accepted 21 September 2013

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rituximab is a chimeric murine-human monoclonal antibody that is directed against the specific B-cell CD20 antigen, which has recently been successfully used in active or refractory systemic lupus erythematosus (SLE) manifestations, such as nephritis, thrombocytopenia, and vasculitis. We report a case of a 25-year-old woman diagnosed with diffuse alveolar hemorrhage of SLE refractory to steroid pulse therapy. The patient was treated successfully with rituximab as a part of the immunosuppressive regimen.

Keywords: Rituximab, Diffuse alveolar hemorrhage, Systemic lupus erythematosus

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Figure 1.

The initial radiologic findings. (A) Chest radiograph showed bilateral diffuse ground glass opacity. (B) High resolution computed tomography scan of the thorax showed bilateral diffuse ground glass opacity, interlobular septal thickening and multifocal consolidation in both basal lung.

Figure 2.

6 weeks after treatment. (A) Chest radiograph showed resolution state of the previous bilateral diffuse ground glass opacity. (B) High resolution computed tomography scan of the thorax showed resolution state of the previous bilateral ground glass opacity, interlobular septal thickening and multifocal consolidation.

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