title: Rituximab-induced Cytokine Storm in the Absence of Overt Lymphoproliferative Disease.
abstract: Rituximab is a monoclonal antibody that first demonstrated efficacy in the treatment of lymphoma but has since seen a dramatic growth in its use for other conditions. Cytokine release syndrome (CRS) is a rare but potentially fatal complication of rituximab infusion that has been described in patients with bulky lymphoproliferative disease. Here we report a convincing case of CRS occurring in a patient with no demonstrable lymphoproliferation. This case has implications for our understanding of the pathogenesis of CRS, our attempts to define an at-risk population and the design of future monoclonal antibodies.
authors.affiliation: Departments of *Paediatric Haematology †Paediatric Immunology, Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Williams
authors.forename: Tasneem
authors.initials: T
authors.lastname: Khalid
authors.forename: Stephen
authors.initials: S
authors.lastname: Hughes
authors.forename: Denise
authors.initials: D
authors.lastname: Bonney
authors.forename: Robert
authors.initials: R
authors.lastname: Wynn
mesh_terms: D016026:Bone Marrow Transplantation; D002648:Child; D015897:Comorbidity; D016207:Cytokines / Q000097:blood*; D004827:Epilepsy / Q000453:epidemiology; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007155:Immunologic Factors / Q000009:adverse effects*; D008297:Male; D015452:Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D000069283:Rituximab / Q000009:adverse effects*
chemical_list: D016207:Cytokines; D007155:Immunologic Factors; D000069283:Rituximab