title: Refractory urticarial vasculitis as a complication of ulcerative colitis successfully treated with rituximab.
abstract: Ulcerative colitis can be complicated by the development of leukocytoclastic vasculitis, a cutaneous vasculitis with the potential for systemic involvement. We present a man with a history of ulcerative colitis complicated by end-stage liver disease secondary to sclerosing cholangitis requiring a liver transplant. The patient developed new-onset vasculitis and diarrhea refractory to therapy with standard immunosuppression. He was treated with anti-CD20 therapy with a positive response. The basis of the vasculitis was likely one related to an underlying monoclonal paraprotein with cryoprecitable properties. Treatment with anti-B-cell therapy may be a new treatment option for patients with gammopathy-associated leukocytoclastic vasculitis.
authors.affiliation: Division of Digestive and Liver Disease, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA. As3576@columbia.edu
authors.forename: Arun
authors.initials: A
authors.lastname: Swaminath
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Magro
authors.forename: Edward
authors.initials: E
authors.lastname: Dwyer
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008297:Male; D000069283:Rituximab; D016896:Treatment Outcome; D014581:Urticaria / Q000188:drug therapy* / Q000209:etiology*; D014657:Vasculitis / Q000188:drug therapy* / Q000209:etiology*
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018501:Antirheumatic Agents; D007155:Immunologic Factors; D000069283:Rituximab