Successful Treatment of ANCA-Associated Vasculitis in the Setting of Common Variable Immunodeficiency Using Rituximab.
Autoimmune diseases such as idiopathic thrombocytopenic purpura and autoimmune hemolytic anemia have a high reported prevalence in patients with common variable immunodeficiency (CVID). We describe the case of a 36-year-old Hispanic man with CVID treated with intravenous immunoglobulin, who developed antineutrophilic cytoplasmic antibodies (ANCA)-associated vasculitis 15 years after immunodeficiency diagnosis. After failing first-line immunosuppressive therapy, the patient was successfully treated with rituximab. Although autoimmunity in the setting of CVID is well documented, this is the first report to describe a case of ANCA-associated vasculitis associated with CVID. Moreover, we report effective and safe use of rituximab in a patient with primary immunodeficiency.
1College of Medicine, University of Toledo, Toledo, OH; 2Department of Pediatrics, University Hospitals Case Medical Center, Cleveland, OH; 3Department of Pathology, University of Toledo, Toledo, OH; 4Department of Pathology, Mercy St Vincent Medical Center, Toledo, OH; and 5Division of Rheumatology, Department of Internal Medicine, University of Toledo, Toledo, OH.
Frank
F
Hill
Jennifer
J
Yonkof
Sri K
SK
Chaitanya Arudra
Jean
J
Thomas
Nezam
N
Altorok
D000328:Adult; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000188:drug therapy* / Q000276:immunology; D017074:Common Variable Immunodeficiency / Q000150:complications* / Q000188:drug therapy; D006630:Hispanic or Latino; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D000069283:Rituximab / Q000009:adverse effects / Q000627:therapeutic use*
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D000069283:Rituximab