title: The use of monoclonal antibody (rituximab) in the treatment of type II mixed cryoglobulinemia.
abstract: Anti-CD20 monoclonal antibody has been successfully used to treat several self-immune diseases. The authors report the case of a 71 year-old female patient under the use of pegylated form of interferon á associated with ribavirin for the treatment of hepatitis C, who, after concluding the therapeutic program - negative Polymerase Chain Reaction (PCR) - developed a severe cutaneous vasculitis, receiving the diagnostic of type II mixed cryoglobulinemia. Four sessions of plasmapheresis were prescribed along the period of 11 days, with no result. The choice made was to administer anti-CD 20 monoclonal antibody (rituximab), 375 mg/m(2), per week, during four consecutive weeks. One could observe fast recovery from the purpura, as well as total remission of urticaria.
authors.affiliation: Oncology Departament, Sírio Libanês Hospital, São Paulo, SP, Brazil. regothiago@yahoo.com.br
authors.forename: Thiago Carlos Gonçalves
authors.initials: TC
authors.lastname: Rego
authors.forename: Celso Mitsushi
authors.initials: CM
authors.lastname: Massumoto
authors.forename: Rodrigo Siqueira
authors.initials: RS
authors.lastname: Batista
authors.forename: Larissa Hanauer de
authors.initials: LH
authors.lastname: Moura
authors.forename: Lygia Maria Costa
authors.initials: LM
authors.lastname: Soares
authors.forename: Andréia Patrícia
authors.initials: AP
authors.lastname: Gomes
mesh_terms: D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000139:chemically induced / Q000188:drug therapy*; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D000069283:Rituximab; C100416:peginterferon alfa-2a