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Vol. 5. Issue 1.
Pages 28-30 (January - February 2009)
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Vol. 5. Issue 1.
Pages 28-30 (January - February 2009)
DOI: 10.1016/S2173-5743(09)70084-X
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
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Rocío Garrido Rasco, Francisco José García Hernández??
Corresponding author
fjgarciah@eresmas.com

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
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Abstract

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).

Keywords:
Systemic lupus erythematosus
Vasculitis
Rituximab
Resumen

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
Rituximab

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