Watanabe Kentaro, Shimada Noriaki, Kanzaki Motoko, Fukuoka Kosuke, Asano Kenichiro
Department of Nephrology, Kurashiki Central Hospital, Japan.
Intern Med. 2025 Feb 15;64(4):581-584. doi: 10.2169/internalmedicine.3357-23. Epub 2024 Jul 18.
An underestimated side effect of rituximab is late-onset neutropenia (R-LON), which often resolves spontaneously and rarely results in a severe infection. We herein report a case of febrile neutropenia due to R-LON in a 91-year-old woman with renal failure who was treated with rituximab to induce remission of myeloperoxidase antineutrophil cytoplasmic antibodies-associated vasculitis. Fifty-four days after the last rituximab administration, the patient was hospitalized for febrile neutropenia due to R-LON, which improved with granulocyte colony-stimulating factor and antibiotics. Although R-LON may resolve spontaneously and remain unnoticed, it can cause severe infections in the elderly and patients with renal failure.
利妥昔单抗一个被低估的副作用是迟发性中性粒细胞减少症（R-LON），这种情况通常会自发缓解，很少导致严重感染。我们在此报告一例91岁患有肾衰竭的女性因R-LON导致发热性中性粒细胞减少症的病例，该患者接受利妥昔单抗治疗以诱导髓过氧化物酶抗中性粒细胞胞浆抗体相关血管炎缓解。在最后一次使用利妥昔单抗54天后，患者因R-LON导致发热性中性粒细胞减少症住院，经粒细胞集落刺激因子和抗生素治疗后病情好转。尽管R-LON可能会自发缓解且未被注意到，但它可能在老年人和肾衰竭患者中引发严重感染。
