title: Rituximab-related late-onset neutropenia in patients with rheumatic diseases: successful re-challenge of the treatment.
abstract: BACKGROUND
  We describe here 2 patients who developed late-onset neutropenia after Rituximab treatment. While this phenomenon is well described among patients suffering from hematological malignancies, such adverse effects are rare among patients with rheumatic diseases.
  
  
  METHODS
  Two patients, the first with rheumatoid arthritis and the second with granulomatosis with polyangiitis, were treated by Rituximab after all previous treatments failed. The patients developed late-onset neutropenia after several courses of treatment. The first patient, with symptomatic neutropenia, recovered after a single dose of granulocyte macrophage stimulating factor, and the second patient's neutrophils increased spontaneously. Both patients were retreated by rituximab in their scheduled time without further complications.
  
  
  CONCLUSIONS
  Our case series is unique because the same phenomenon appeared in patients with different rheumatic diseases. This case series confirms the possibility of continuing the treatment without further adverse effects.
authors: Department of Rheumatology, Barsilai Medical Center, Ashkelon, Israel.
authors: Tatiana
authors: T
authors: Reitblat
authors: Department of Nephrology, Barsilai Medical Center, Ashkelon, Israel.
authors: Alexander
authors: A
authors: Wechsler
authors: Department of Rheumatology, Barsilai Medical Center, Ashkelon, Israel.
authors: Olga
authors: O
authors: Reitblat
mesh_terms: D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005500:Follow-Up Studies; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced* / Q000188:drug therapy; D000069283:Rituximab / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D000069283:Rituximab; D016178:Granulocyte-Macrophage Colony-Stimulating Factor