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  • Title: Successful rituximab therapy in a lupus patient with diffuse alveolar haemorrhage.
    Author: Pottier V, Pierrot M, Subra JF, Mercat A, Kouatchet A, Parrot A, Augusto JF.
    Journal: Lupus; 2011 May; 20(6):656-9. PubMed ID: 21335399.
    Abstract:
    Diffuse alveolar haemorrhage (DAH) is a rare but life-threatening complication of systemic lupus erythematosus (SLE). Specific therapy is based on a heavy immunosuppressive treatment that usually associates corticosteroid and cyclophosphamide boluses and plasma exchange. Despite this treatment, an early mortality rate of 20-50% is reported in the literature. Immunosuppression-related complications are responsible for further mortality and morbidity. Rituximab, a specific anti-CD20 antigen B-cell antibody, has been used with success for the treatment of several refractory autoimmune disorders, but rarely for SLE-induced DAH. We report here the first case of SLE-induced DAH treated successfully with rituximab without cyclophosphamide administration in a patient intolerant to cyclophosphamide. We review the two other cases of SLE-induced DAH managed with rituximab as a part of the immunosuppressive regimen.
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