title: Successful outcome of a corticodependent henoch-schönlein purpura adult with rituximab.
abstract: Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving small vessels with deposition of immunoglobulin A (IgA) complexes, usually affecting children. Compared with children, HSP in adults is more severe and frequently associated with cancer. We report the case of a 49-year-old woman with medical history of kidney transplantation for segmental glomerular hyalinosis. Eight years after the transplantation, while taking combined immunosuppressive therapy with tacrolimus and azathioprine indicated for the prevention against transplant rejection, she developed a Henoch-Schönlein purpura. Vasculitis involves skin and sciatic peroneal nerve and she received systemic corticosteroid treatment. Because of four relapses and corticosteroid dependence, the patient was treated with rituximab (two intravenous infusions of 1000 mg given two weeks apart). Successful outcome was observed along two years of follow-up. This new case of successful use of rituximab in HSP promotes more investigations of this treatment in clinical trials.
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Taylor
authors.initials: T
authors.lastname: Pindi Sala
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France ; Faculty of Medicine Paris-Sud, 94276 Le Kremlin-Bicêtre Cedex, France.
authors.forename: Jean-Marie
authors.identifier: 0000-0002-3349-6079
authors.initials: JM
authors.lastname: Michot
authors.affiliation: Department of Nephrology and Adult Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Necker Enfants-Malades Hospital, 75015 Paris, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Snanoudj
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Marion
authors.identifier: 0000-0002-5186-7275
authors.initials: M
authors.lastname: Dollat
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Estève
authors.affiliation: Faculty of Medicine Paris-Sud, 94276 Le Kremlin-Bicêtre Cedex, France ; Hematology and Immunology Biological Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Marie
authors.affiliation: Faculty of Medicine Paris-Sud, 94276 Le Kremlin-Bicêtre Cedex, France ; Hematology and Immunology Biological Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Yacine
authors.initials: Y
authors.lastname: Taoufik
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France ; Faculty of Medicine Paris-Sud, 94276 Le Kremlin-Bicêtre Cedex, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Delfraissy
authors.affiliation: Department of Pathology, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lazure
authors.affiliation: Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Bicêtre Hospital, 94275 Le Kremlin-Bicêtre, France ; Faculty of Medicine Paris-Sud, 94276 Le Kremlin-Bicêtre Cedex, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Lambotte