[Rheumatoid arthritis and autoimmune hemolysis: B-cell depletion for remission induction in a patient with rheumatoid arthritis and cold agglutinin disease].
Autoimmune hemolysis is a rare complication of systemic rheumatic diseases. We report on a 68-year-old female patient with established, long-standing rheumatoid arthritis, who complained of progressive weakness and worsening of her arthralgia under therapy with leflunomide. Physical and laboratory examination revealed autoimmune hemolysis due to cold agglutinin disease. As hemolysis and arthritis were refractory to steroid treatment, B-cell depletion with rituximab was performed leading to a marked reduction of hemolytic parameters as well as remission of her rheumatoid arthritis.
Lehmann
P
P
Klinik und Poliklinik für Innere Medizin I, Universitätsklinikum Regensburg, 93042 Regensburg. petra.lehmann@klinik.uni-regensburg.de
Hartung
W
W
Ehrenstein
B
B
Schölmerich
J
J
Fleck
M
M
D000368:Aged; D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D001402:B-Lymphocytes / Q000276:immunology*; D003450:Cryoglobulins / Q000276:immunology; D005260:Female; D006801:Humans; D007146:Immunoglobulin lambda-Chains / Q000276:immunology; D008212:Lymphocyte Depletion; D000069283:Rituximab
D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D003450:Cryoglobulins; D007146:Immunoglobulin lambda-Chains; C029443:cold agglutinins; D000069283:Rituximab