Revmatologisk avdeling, Nevro-og ortopediklinikken, Universitetssykehuset Nord-Norge, Postboks 14, 9038 Tromsø, Norway.
Rheumatol Int. 2013 Jun;33(6):1643-4. doi: 10.1007/s00296-011-2353-5. Epub 2011 Dec 30.
We report two patients with granulomatosis with polyangiitis in remission with rituximab maintenance therapy with sustained hypogammaglobulinemia. Both patients had serious infections and were admitted to the intensive therapy unit. The patients had at least low IgM levels prior to the initiation of rituximab. They received cyclophosphamide and prednisolone at induction and at maintenance. They had lung affection, low level of both IgM and IgG and a cumulative dose of rituximab over 7 g at the time of the severe infection. Our patients have features similar to common variable immunodeficiency patients, and therefore prolonged very low levels of immunoglobulins could heighten the risk for severe infections.
我们报告了两例接受利妥昔单抗维持治疗的缓解期肉芽肿伴多血管炎患者，他们的免疫球蛋白持续低下。这两名患者均因严重感染而住进重症监护病房。在开始使用利妥昔单抗之前，两名患者的 IgM 水平至少较低。在诱导和维持治疗中，他们都接受了环磷酰胺和泼尼松龙治疗。他们有肺部受累，IgM 和 IgG 水平均低，在严重感染时利妥昔单抗的累积剂量超过 7 克。我们的患者具有类似于普通可变免疫缺陷患者的特征，因此，免疫球蛋白的极低水平持续时间延长可能会增加严重感染的风险。
