Long-term efficacy of rituximab in hepatitis C virus-associated cryoglobulinemia

Mixed cryoglobulinemia is one of the most closely related extrahepatic manifestations of hepatitis C virus and requires a challenging therapeutic approach depending on the severity of the symptoms. Here, we describe the long-term follow-up of a patient with important cutaneous, articular and neural...

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Bibliographic Details
Published in:Rheumatology international 2010-09, Vol.30 (11), p.1515-1518
Main Authors: da Silva Fucuta Pereira, Patricia, Lemos, Lara Barros, de Oliveira Uehara, Silvia Naomi, de Souza e Silva, Ivonete Sandra, Silva, Antonio Eduardo Benedito, Ferraz, Maria Lucia Gomes
Format: Article
Language:English
Subjects:
Adult
Antibodies, Monoclonal, Murine-Derived - therapeutic use
Antirheumatic Agents - pharmacology
Antirheumatic Agents - therapeutic use
Blood diseases
Case Report
Cryoglobulinemia - drug therapy
Cryoglobulinemia - immunology
Drug efficacy
Female
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - complications
Hepatitis C, Chronic - immunology
Humans
Immunotherapy
Interferon
Medicine
Medicine & Public Health
Monoclonal antibodies
Rheumatology
Rituximab
Time
Treatment Outcome
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Summary:Mixed cryoglobulinemia is one of the most closely related extrahepatic manifestations of hepatitis C virus and requires a challenging therapeutic approach depending on the severity of the symptoms. Here, we describe the long-term follow-up of a patient with important cutaneous, articular and neural manifestations of cryoglobulinemia associated with chronic hepatitis C treated with rituximab. A 42-year-old woman who did not respond to previous interferon-based treatments (standard and pegylated interferon plus ribavirin) and corticosteroids was subjected to treatment with rituximab at a dose of 375 mg/m² per week for 4 consecutive weeks. The drug was well tolerated and complete improvement of arthralgia was immediately evident. There was gradual improvement of lower limbs paresthesia and healing of a leg ulcer that had been active for 5 years. The clinical and immunological responses induced by rituximab are sustained over long-term follow-up, and this case illustrates the drug efficacy for non-responder patients to antiviral therapy.
ISSN:0172-8172
1437-160X
DOI:10.1007/s00296-009-1106-1