Severe pneumonia with formation of a pulmonary cavity associated with long-term rituximab therapy in multiple sclerosis.

Neurol Res Pract

Department of Neurology, St. Josef-Hospital, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany.

Published: October 2020

AI Article Synopsis

  • B-cell depletion using anti-CD20 antibodies is a common treatment for multiple sclerosis (MS), but there is limited understanding of the infection risks tied to this long-term therapy.
  • A case is presented of a 45-year-old man who developed severe pneumonia after six years of rituximab treatment for highly active relapsing-remitting MS, despite having no significant pre-existing health issues.
  • The patient ultimately recovered after a course of antibiotics, highlighting the serious infection risks associated with prolonged B-cell depletion and emphasizing the need for increased awareness in managing such patients.

Article Abstract

Nowadays B-cell depletion via anti-CD20 antibodies is commonly applied in the treatment of multiple sclerosis (MS). Yet, not much is known about infection risks associated with long-term B-cell depletion in the specific context of MS. We present the case of a 45-year-old male patient who developed severe pneumonia following 6 years of rituximab treatment for highly active relapsing-remitting MS. The patient had no additional chronic disease as well as no history of foreign travel. Although the unusual formation of a pulmonary cavity raised suspicion for tuberculosis, repeated testing via bronchoscopy and sputum remained negative. Prolonged antibiotic therapy with piperacillin/tazobactam and amoxicillin/ clavulanate led to complete recovery from symptoms. This case shows the potential risk of serious infections following continuous B-cell depletion in MS and illustrates the importance of future vigilance.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7650061PMC
http://dx.doi.org/10.1186/s42466-020-00074-0DOI Listing

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