Publish in this journal
Journal Information
Vol. 5. Issue 1.
Pages 28-30 (January - February 2009)
Download PDF
More article options
Vol. 5. Issue 1.
Pages 28-30 (January - February 2009)
Full text access
Efficacy of Rituximab Combined With Wyclophosphamide in a Patient With Systemic Lupus Erythematosus and Peritoneal Vasculitis Refractory to Conventional Inmunosupressive Therapy
Eficacia de rituximab combinado con ciclofosfamida en una paciente con lupus eritematoso sistémico y vasculitis peritoneal resistente a tratamiento inmunosupresor convencional
Rocío Garrido Rasco, Francisco José García Hernández
Corresponding author

Corresponding author.
, Rocío González León, María Jesús Castillo Palma, Celia Ocaña Medina, Julio Sánchez Román
Unidad de Colagenosis e Hipertensión Pulmonar, Servicio de Medicina Interna, Hospitales Universitarios Virgen del Rocío, Sevilla, Spain
This item has received
Article information
Download PDF

Peritoneal vasculitis is a rare and severe clinical manifestation of systemic lupus erythematosus. We report a patient who presented with ascites due to peritoneal vasculitis and cutaneous, articular, hematological, and renal inflammatory activity. Treatment with glucocorticoids and immunosuppressive drugs was ineffective. In view of the resistance to different therapies, 4 weekly infusions of 375mg/m2 of rituximab (RTX) were started, in association with cyclophosphamide pulses during the first and the third weeks. With this treatment strategy, the patient reached a complete response which was achieved in later flares of inflammatory activity (the second and third flares were multisystemic and with ascites again, and the fourth flare with nephritis).

Systemic lupus erythematosus

La vasculitis peritoneal es una manifestación clínica infrecuente y grave del lupus eritematoso sistémico. Se presenta el caso de una paciente con ascitis por vasculitis peritoneal y afección cutánea, articular, hemática y renal. El tratamiento con glucocorticoides e inmunosupresores resultó ineficaz para el control de la ascitis. Dada la resistencia al tratamiento convencional, se administró rituximab en cuatro infusiones semanales de 375mg/m2, potenciado con pulsos de ciclofosfamida las semanas 1 y 3. Con esta estrategia se consiguió una respuesta completa, que se repitió en brotes posteriores (el segundo y el tercero, multisistémicos y de nuevo con ascitis significativa, y el cuarto con nefritis).

Palabras clave:
Lupus eritematoso sistémico ;Vasculitis
Full text is only aviable in PDF
L.S. Toy, L. Mayer.
Nonhepatic gastrointestinal manifestations of systemic lupus erythematosus.
Systemic lupus erythematosus, 3rd ed, pp. 733-746
S.M. Sultan, Y. Ioannou, D.A. Issenberg.
A review of gastrointestinal manifestations of systemic lupus erythematosus.
Rheumatology, 38 (1999), pp. 917-932
E.T. Ko, L.M. Boey, P.H. Feng.
Acute surgical abdomen in systemic lupus erythematosus analysis of ten cases.
Ann Acad Med Singapore, 21 (1992), pp. 833-837
J.Y. Byun, H.K. Ha, S.Y. Yu, J.K. Min, S.H. Park, H.Y. Kim, et al.
CT features of systemic lupus erythematosus in patients with acute abdominal pa emphasis on ischemic bowel disease.
A.C. Buck, L.H. Serebro, R.J. Quinet.
Subacute abdominal pain requiring hospitalization in a systemic lupus erythematosus patient: a retrospective analysis and review of the literature.
Lupus, 10 (2001), pp. 491-495
B. Naylor.
Cytological aspects of pleural, peritoneal and pericardial fluids from patients with systemic lupus erythematosus.
Cytopathology, 3 (1992), pp. 1-8
C. Pagnoux, A. Mahr, P. Cohen, L. Guillevin.
Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides.
Medicine, 84 (2005), pp. 115-128
S.E. Rha, H.K. Ha, S.H. Lee, J.-H. Kim, J.-K. Kim, J.H. Kim, et al.
CT and MR imaging findings of bowel ischemia from various primary causes.
B.J. Fessler, G.S. Hoffman.
SLE and the cardiovascular system: vasculitis.
Systemic lupus erythematosus, 3rd ed, pp. 707-717
F.J. García Hernández, C. Ocaña Medina, R. González León, R. Garrido Rasco, R. Colorado Bonilla, M.J. Castillo Palma, et al.
Utilidad del rituximab en el tratamiento de pacientes con enfermedades sistémicas autoinmunitarias.
Med Clin (Barc), 128 (2007), pp. 458-462
L. Waite, E. Morrison.
Severe gastrointestinal involvement in systemic lupus erythematosus treated with rituximab and cyclophosphamide (B-cell depletion therapy).
Lupus, 16 (2007), pp. 841-842
Copyright © 2009. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
Reumatología Clínica (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?