title: Long-term efficacy of rituximab in hepatitis C virus-associated cryoglobulinemia.
abstract: 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/m(2) 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.
authors.affiliation: Hepatitis Section, Division of Gastroenterology, Federal University of Sao Paulo, Rua Botucatu, 740, 2 degrees andar, São Paulo, 04023-900, Brazil, patriciafucuta@gmail.com.
authors.forename: Patricia
authors.initials: P
authors.lastname: da Silva Fucuta Pereira
authors.forename: Lara Barros
authors.initials: LB
authors.lastname: Lemos
authors.forename: Silvia Naomi
authors.initials: SN
authors.lastname: de Oliveira Uehara
authors.forename: Ivonete Sandra
authors.initials: IS
authors.lastname: de Souza E Silva
authors.forename: Antonio Eduardo Benedito
authors.initials: AE
authors.lastname: Silva
authors.forename: Maria Lucia Gomes
authors.initials: ML
authors.lastname: Ferraz
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000188:drug therapy* / Q000276:immunology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000276:immunology*; D006801:Humans; D000069283:Rituximab; D013995:Time; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D000069283:Rituximab
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