title: Rituximab-induced neutropenia in a patient with inflammatory myopathy and systemic sclerosis overlap disease.
abstract: Rituximab (RTX) is a monoclonal chimeric antibody directed against the CD20 antigen of B lymphocytes. Late onset neutropenia (LON) is a recognised complication of rituximab usually occurring 4 weeks after the last dose and is reported in both haematological and rheumatological conditions. However, it has never been described in a patient with myositis and systemic sclerosis overlap disease. We describe a case of LON in a 54-year-old man who was diagnosed with myositis and then systemic sclerosis overlap disease. It resolved within 7 days, and the patient did not suffer neutropenic sepsis or any other complications. We propose similar mechanisms for LON as described in other conditions and routine blood monitoring in such patients.
authors.affiliation: Rheumatology Department, Salford Royal Foundation Trust, Manchester, United Kingdom.
authors.forename: Qasim
authors.initials: Q
authors.lastname: Akram
authors.affiliation: Neurology Department, Salford Royal Foundation Trust, Manchester, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Roberts
authors.affiliation: Division of Rheumatology and Clinical Immunology, University of Pittsburgh, Pennsylvania, USA.
authors.forename: Chester
authors.initials: C
authors.lastname: Oddis
authors.affiliation: Rheumatology Department, Salford Royal Foundation Trust, Manchester, United Kingdom.
authors.forename: Arianne
authors.initials: A
authors.lastname: Herrick
authors.affiliation: Rheumatology Department, Salford Royal Foundation Trust, Manchester, United Kingdom.
authors.forename: Hector
authors.initials: H
authors.lastname: Chinoy
keywords: myositis; neutropenia; rituximab; systemic sclerosis