title: A case of refractory polyarteritis nodosa successfully treated with rituximab.
abstract: A 59-year-old man who presented with continuous fever, livedo reticularis, and left leg ischemia with multiple tibial artery stenosis and renal artery aneurysm, as demonstrated by arteriography, was diagnosed with polyarteritis nodosa (PAN) 6 years ago. Although he frequently relapsed in spite of intensive immunosuppressive therapies, the disease activity of PAN was controlled with repeated rituximab (RTX) therapies and steroid doses were tapered safely. Peripheral CD19+B-cells disappeared soon after the 1st administration of RTX. Although CD19+B-cells remained absent, 3.1% of CD3+CD20+T-cells were observed in the peripheral blood prior to the 2nd administration of RTX. Recent studies have suggested the pathogenic role of CD3+CD20+T-cells in autoimmune diseases in the context of RTX therapy; therefore, their roles in the pathogenesis of PAN also need to be considered.
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Yu
authors: Y
authors: Seri
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Hirofumi
authors: H
authors: Shoda
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Norio
authors: N
authors: Hanata
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Yasuo
authors: Y
authors: Nagafuchi
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Shuji
authors: S
authors: Sumitomo
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Keishi
authors: K
authors: Fujio
authors: a Department of Allergy and Rheumatology , Graduate School of Medicine, the University of Tokyo , Tokyo , Japan.
authors: Kazuhiko
authors: K
authors: Yamamoto
mesh_terms: D001402:B-Lymphocytes / Q000187:drug effects; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010488:Polyarteritis Nodosa / Q000188:drug therapy*; D000069283:Rituximab / Q000008:administration & dosage / Q000627:therapeutic use*; D013601:T-Lymphocytes / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors; D000069283:Rituximab
keywords: B-cell; Polyarteritis nodosa; Rituximab; T-cell