Rituximab-induced regression of CREST-related calcinosis

About a quarter of sclerodermic patients present calcinosis. However, patients with limited form of the disease are more likely to have calcinosis than patients with diffuse form. We report a case of a 54-year-old female patient with limited cutaneous scleroderma using rituximab (RTX) to treat lung fibrosis and arthritis. Into RTX treatment, she also had a complete resolution of calcinosis in her hands. The patient reported improvement in dyspnea and synovitis after two courses of RTX (four weekly infusions 375 mg/m(2) each). After 7 months of the first infusion, the calcinosis in her fingers had a complete remission, especially the right thumb. Based on current evidences, we discuss the use of rituximab as a promising therapy to treat not only lung disease but also calcinosis in patients with scleroderma.