title: Rapid exacerbation of neuromyelitis optica after rituximab treatment.
abstract: Studies have shown the efficacy of immunosuppressants against neuromyelitis optica (NMO). Rituximab is recommended as an off-label prescription to treat refractory NMO. However, we describe two such patients who were suboptimally responsive to rituximab and whose symptoms worsened after treatment. Our cautionary cases highlight that in a small proportion of patients with refractory NMO, rituximab may either fail or induce rapid relapse of NMO. This suggests we need to consider new treatment strategies for refractory NMO.
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Dai
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Lu
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.
authors.forename: Yuge
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Fang
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Department of Neurology, Sir Charles Gairdner Hospital, Queen Elizabeth II Medical Centre, WA, Australia; Institute of Immunology and Infectious Diseases, Murdoch University, WA, Australia.
authors.forename: Allan G
authors.initials: AG
authors.lastname: Kermode
authors.affiliation: Department of Neurology, Third Affiliated Hospital of Sun Yat-sen University, No. 135, Xingang Xi Road, Guangzhou 510275, China. Electronic address: qw9406@gmail.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Qiu
mesh_terms: D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D009471:Neuromyelitis Optica / Q000188:drug therapy*; D012008:Recurrence; D000069283:Rituximab / Q000009:adverse effects*
chemical_list: D007166:Immunosuppressive Agents; D000069283:Rituximab
keywords: Neuromyelitis optica; Relapse; Rituximab; Therapy