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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
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A Case of Interstitial Lung Disease Probably Related to Rituximab Treatment

Massimo Calderazzo1, Pierandrea Rende2,3, Paolo Gambardella1

  • 1Department of Infectious Disease, ASP Lamezia Terme, Catanzaro, Italy.

Drug Safety - Case Reports
|October 18, 2016
PubMed

A 44-year-old male developed interstitial lung disease (ILD) during treatment with rituximab (375 mg/m2 weekly intravenous × 4 weeks) for the management of immune thrombocytopenia (ITP). After 1 month of treatment he developed dyspnea, fever (38.9 °C), an increase of C-reactive protein (CRP) and white blood cells with hypoxemia, and decreased platelets. Chest X-ray and high-resolution computed tomography revealed diffuse bilateral lung infiltrates. He was diagnosed with severe ILD; rituximab was discontinued, and treatment with fluticasone combined with salmeterol, methylprednisolone, and omeprazole was started, with an improvement of symptoms over 15 days with normalization in CRP at 30 days. A Naranjo assessment score of 6 was obtained, indicating a probable relationship between the patient's symptoms and the suspect drug. In conclusion, in ITP patients treated with rituximab, we suggest evaluating pulmonary endpoints through pharmaco-epidemiological observational studies.

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