Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with unpredictable course and flares. The clinical manifestation can vary from mild to severe and life-threatening disease. Infection is the primary cause of mortality in hospitalized SLE patients. There is a paucity of evidence to s...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2022/5899188 |
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| author | Mohamed M. Cheikh Abdullah K. Bahakim Moayad K. Aljabri Saad M. Alharthi Sanad M. Alharthi Abdullah K. Alsaeedi Saad F. Alqahtani |
| author_facet | Mohamed M. Cheikh Abdullah K. Bahakim Moayad K. Aljabri Saad M. Alharthi Sanad M. Alharthi Abdullah K. Alsaeedi Saad F. Alqahtani |
| author_sort | Mohamed M. Cheikh |
| collection | DOAJ |
| description | Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with unpredictable course and flares. The clinical manifestation can vary from mild to severe and life-threatening disease. Infection is the primary cause of mortality in hospitalized SLE patients. There is a paucity of evidence to support the co-management of SLE with major organ involvement and sepsis. We describe the clinical response of a 35-year-old male diagnosed with SLE; then, he developed severe sepsis and a flare of SLE with major organ involvement including lupus nephritis (LN), myocarditis, and neuropsychiatric systemic lupus erythematosus (NPSLE). Based on the patient’s condition, a treatment dilemma was encountered, and after a multidisciplinary meeting, the decision was made to use a combination of rituximab (RTX), intravenous immunoglobulin (IVIG), and pulse steroid. Shortly, the patient’s condition started to improve, and his symptoms were resolved. In conclusion, our clinical case suggests that combined RTX, IVIG, and pulse steroid seem to be effective and safe in achieving clinical response, thus representing a good choice for managing severe SLE flares in sepsis. |
| format | Article |
| id | doaj-art-da47e8c23ee949f1be5dcb323adf655a |
| institution | Kabale University |
| issn | 2090-6897 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-da47e8c23ee949f1be5dcb323adf655a2025-02-03T05:50:40ZengWileyCase Reports in Rheumatology2090-68972022-01-01202210.1155/2022/5899188Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of CareMohamed M. Cheikh0Abdullah K. Bahakim1Moayad K. Aljabri2Saad M. Alharthi3Sanad M. Alharthi4Abdullah K. Alsaeedi5Saad F. Alqahtani6Department of MedicineDepartment of Medicine and SurgeryDepartment of Medicine and SurgeryInternal Medicine DepartmentInternal Medicine DepartmentInternal Medicine DepartmentInternal Medicine DepartmentSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with unpredictable course and flares. The clinical manifestation can vary from mild to severe and life-threatening disease. Infection is the primary cause of mortality in hospitalized SLE patients. There is a paucity of evidence to support the co-management of SLE with major organ involvement and sepsis. We describe the clinical response of a 35-year-old male diagnosed with SLE; then, he developed severe sepsis and a flare of SLE with major organ involvement including lupus nephritis (LN), myocarditis, and neuropsychiatric systemic lupus erythematosus (NPSLE). Based on the patient’s condition, a treatment dilemma was encountered, and after a multidisciplinary meeting, the decision was made to use a combination of rituximab (RTX), intravenous immunoglobulin (IVIG), and pulse steroid. Shortly, the patient’s condition started to improve, and his symptoms were resolved. In conclusion, our clinical case suggests that combined RTX, IVIG, and pulse steroid seem to be effective and safe in achieving clinical response, thus representing a good choice for managing severe SLE flares in sepsis.http://dx.doi.org/10.1155/2022/5899188 |
| spellingShingle | Mohamed M. Cheikh Abdullah K. Bahakim Moayad K. Aljabri Saad M. Alharthi Sanad M. Alharthi Abdullah K. Alsaeedi Saad F. Alqahtani Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care Case Reports in Rheumatology |
| title | Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care |
| title_full | Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care |
| title_fullStr | Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care |
| title_full_unstemmed | Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care |
| title_short | Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care |
| title_sort | neuropsychiatric lupus and lupus nephritis successfully treated with combined ivig and rituximab an alternative to standard of care |
| url | http://dx.doi.org/10.1155/2022/5899188 |
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