title: A case of primary biliary cirrhosis that progressed rapidly after treatment involving rituximab.
abstract: Primary biliary cirrhosis (PBC) is a progressive liver disease for which limited therapies are recommended. Rituximab, an anti-CD20 monoclonal antibody, is expected to be a useful therapeutic regimen for PBC. Previous studies indicated biochemical and immunological improvement in PBC after rituximab treatment. Although rituximab shows therapeutic potential for PBC, few cases have been reported and histological improvement and long-term outcome remain uncertain. Here, we report a case of PBC in a 66-year-old Japanese female patient who presented with a gastric lymphoma and who had been treated with a regimen containing rituximab for incidental malignant lymphoma. She showed biochemical and immunological improvements, and liver histology before and after rituximab treatment confirmed a decrease in liver inflammation. However, she developed liver cirrhosis a short time after rituximab treatment without biochemical or immunological worsening. Rituximab treatment for PBC might be considered and careful observation is required after treatment.
authors.affiliation: The Third Department of Internal Medicine, Toyama University Hospital, Toyama, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Tajiri
authors.forename: Koichi
authors.initials: K
authors.lastname: Tsuneyama
authors.forename: Takahiro
authors.initials: T
authors.lastname: Miyazono
authors.forename: Kengo
authors.initials: K
authors.lastname: Kawai
authors.forename: Masami
authors.initials: M
authors.lastname: Minemura
authors.forename: Toshiro
authors.initials: T
authors.lastname: Sugiyama
keywords: Primary biliary cirrhosis; Rituximab; Transforming growth factor beta