title: Successful treatment with rituximab of an infant with refractory autoimmune hemolytic anemia.
abstract: Autoimmune hemolytic anemia (AIHA) is a rare disease in infants, for which steroids are recognized as a first-line therapy for patients. Rituximab, a humanized monoclonal antibody raised against CD20, has been used in the treatment of autoimmune diseases, including AIHA, in adults and children. Due to limited follow-up study of the use of rituximab in the treatment for AIHA, its long-term efficacy, adverse effects, and immunological reconstitution of B cells have not been fully evaluated in infants. Here, we report a 3-month-old female patient with refractory AIHA, who was successfully treated with rituximab. Hemolytic anemia improved rapidly, and there were no severe adverse effects caused by rituximab. After 4.5 months following rituximab treatment, peripheral B cells were gradually reconstituted and required no intravenous immunoglobulin replacement thereafter. The patient has remained disease-free for more than 30 months without any additional treatment. This case suggests that rituximab may be a valuable therapeutic option, given its efficacy and minimal adverse effects in infants with therapy-resistant AIHA.
authors.affiliation: Department of Pediatrics, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Moriya
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Matsuhashi
authors.forename: Masaei
authors.initials: M
authors.lastname: Onuma
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Niizuma
authors.forename: Takeshi
authors.initials: T
authors.lastname: Rikiishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Asada
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Yoji
authors.initials: Y
authors.lastname: Sasahara
authors.forename: Shigeo
authors.initials: S
authors.lastname: Kure
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000175:diagnosis / Q000188:drug therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007223:Infant; D012074:Remission Induction; D000069283:Rituximab; D013997:Time Factors
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D000069283:Rituximab