title: Rituximab induced pulmonary fibrosis in a patient with lupus nephritis.
abstract: We describe a 26-year-old woman who was diagnosed eleven years ago with systemic lupus erythematosus and who had suffered multiple relapses. She presented with class IV lupus nephritis with thrombotic microangiopathy, for which she received three doses of rituximab along with plasmapheresis, with no response, and soon became dialysis dependent. One month after the last dose of rituximab, she presented with dyspnoea and hypoxia. A transbronchial lung biopsy revealed pulmonary fibrosis. A diagnosis of rituximab induced pulmonary fibrosis was made after excluding other causes and she was treated with intravenous methyl prednisolone with which there was marked improvement in symptoms and hypoxemia. This is the first report of rituximab induced pulmonary fibrosis in a patient with lupus nephritis.
authors.affiliation: Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drmanishrathi2000@yahoo.co.in
authors.forename: M
authors.initials: M
authors.lastname: Rathi
authors.forename: R
authors.initials: R
authors.lastname: Ramachandran
authors.forename: S
authors.initials: S
authors.lastname: Gundlapalli
authors.forename: R
authors.initials: R
authors.lastname: Agarwal
authors.forename: A
authors.initials: A
authors.lastname: Das
authors.forename: V
authors.initials: V
authors.lastname: Kumar
authors.forename: H S
authors.initials: HS
authors.lastname: Kohli
authors.forename: V
authors.initials: V
authors.lastname: Jha
authors.forename: V
authors.initials: V
authors.lastname: Sakhuja
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000628:therapy; D008181:Lupus Nephritis / Q000628:therapy*; D008775:Methylprednisolone / Q000627:therapeutic use; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D000069283:Rituximab
chemical_list: D000305:Adrenal Cortex Hormones; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D008775:Methylprednisolone