Sjögren keratoconjunctivitis sicca treated with rituximab.
OBJECTIVE
To report two clinical cases of patients having severe keratoconjunctivitis sicca refractive to conventional treatment that received rituximab, a chimeric monoclonal antibody specific for human CD20 that targets B lymphocytes.


METHODS
Clinical description and review of the literature.


RESULTS
After treatment with rituximab, there was a marked improvement in their keratoconjunctivitis sicca and in other systemic manifestations of the disease. The patients also report a better quality of life in regard to sicca symptoms. B cells seem to play an important role in the pathogenesis of Sjögren syndrome. Rituximab produces immunoablation and has been used in various autoimmune diseases and cancer with a secure profile.


CONCLUSIONS
We demonstrate improvement in Schirmer test values, tear film breakup time, visual acuity, symptomatology, and vital staining in two patients with refractory queratoconjunctivitis sicca secondary to Sjögren syndrome. It is probable that drugs like rituximab could be of help in patients in unresponsive cases of keratoconjunctivitis sicca secondary to Sjögren syndrome. This case report serves as the basis to justify a multicenter, randomized, placebo-controlled clinical trial.
Ophthalmology. Corneal and Refractive Surgery Department, Clínica Universitaria Bolivariana, Medellin, Colombia. luiszg70@hotmail.com
Luis Fernando
LF
Zapata
Luz Marina
LM
Agudelo
Jose David
JD
Paulo
Ricardo
R
Pineda
D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology*; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007638:Keratoconjunctivitis Sicca / Q000188:drug therapy*; D008297:Male; D000069283:Rituximab; D014792:Visual Acuity
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D000069283:Rituximab