Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review
Serum sickness is an immune-complex-mediated systemic illness that can occur after treatment with monoclonal or polyclonal antibodies such as Rituxan (Rituximab) or antithymocyte globulin (Thymoglobulin), respectively. Since Rituximab is now being used as an adjuvant treatment for acute humoral reje...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2012/234515 |
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| author | Amarpreet Sandhu Antonia Harford Pooja Singh Eduardo Alas |
| author_facet | Amarpreet Sandhu Antonia Harford Pooja Singh Eduardo Alas |
| author_sort | Amarpreet Sandhu |
| collection | DOAJ |
| description | Serum sickness is an immune-complex-mediated systemic illness that can occur after treatment with monoclonal or polyclonal antibodies such as Rituxan (Rituximab) or antithymocyte globulin (Thymoglobulin), respectively. Since Rituximab is now being used as an adjuvant treatment for acute humoral rejection and its prevalence to cause serum sickness is comparable to Thymoglobulin-associated serum sickness (20% versus 27%), it should be considered a potential cause of serum sickness after rejection treatment. In kidney transplant patients, there are no case reports where patient received both Thymoglobulin and Rituximab before developing serum sickness. We are reporting a patient who developed serum sickness after receiving Thymoglobulin and Rituximab that led us to consider Rituximab as one of the potential causes in this patient’s serum sickness. Since diagnosis of serum sickness is clinical, and Rituximab use has expanded into treatment of glomerulonephritis and acute humoral rejection, it should be considered as a potential offender of serum sickness in these patient populations. There are not any evidence-based guidelines or published clinical trials to help guide therapy for antibody-induced serum sickness; however, we successfully treated our case with three doses of Methylprednisone 500 mg intravenously. Further studies are needed to evaluate Rituximab-associated serum sickness in nephrology population to find effective treatment options. |
| format | Article |
| id | doaj-art-4ce05f362a8e446995b223d43d996a13 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-4ce05f362a8e446995b223d43d996a132025-02-03T06:07:54ZengWileyCase Reports in Medicine1687-96271687-96352012-01-01201210.1155/2012/234515234515Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature ReviewAmarpreet Sandhu0Antonia Harford1Pooja Singh2Eduardo Alas3Department of Nephrology, The University of New Mexico, Albuquerque, NM 87131, USADepartment of Nephrology, The University of New Mexico, Albuquerque, NM 87131, USADepartment of Nephrology, The University of New Mexico, Albuquerque, NM 87131, USADepartment of Nephrology, The University of New Mexico, Albuquerque, NM 87131, USASerum sickness is an immune-complex-mediated systemic illness that can occur after treatment with monoclonal or polyclonal antibodies such as Rituxan (Rituximab) or antithymocyte globulin (Thymoglobulin), respectively. Since Rituximab is now being used as an adjuvant treatment for acute humoral rejection and its prevalence to cause serum sickness is comparable to Thymoglobulin-associated serum sickness (20% versus 27%), it should be considered a potential cause of serum sickness after rejection treatment. In kidney transplant patients, there are no case reports where patient received both Thymoglobulin and Rituximab before developing serum sickness. We are reporting a patient who developed serum sickness after receiving Thymoglobulin and Rituximab that led us to consider Rituximab as one of the potential causes in this patient’s serum sickness. Since diagnosis of serum sickness is clinical, and Rituximab use has expanded into treatment of glomerulonephritis and acute humoral rejection, it should be considered as a potential offender of serum sickness in these patient populations. There are not any evidence-based guidelines or published clinical trials to help guide therapy for antibody-induced serum sickness; however, we successfully treated our case with three doses of Methylprednisone 500 mg intravenously. Further studies are needed to evaluate Rituximab-associated serum sickness in nephrology population to find effective treatment options.http://dx.doi.org/10.1155/2012/234515 |
| spellingShingle | Amarpreet Sandhu Antonia Harford Pooja Singh Eduardo Alas Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review Case Reports in Medicine |
| title | Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review |
| title_full | Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review |
| title_fullStr | Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review |
| title_full_unstemmed | Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review |
| title_short | Is Thymoglobulin or Rituximab the Cause of This Serum Sickness? A Case Report of Serum Sickness Dilemma and Literature Review |
| title_sort | is thymoglobulin or rituximab the cause of this serum sickness a case report of serum sickness dilemma and literature review |
| url | http://dx.doi.org/10.1155/2012/234515 |
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