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Rituximab-induced lung disease: a systematic literature review
European Respiratory Journal , 07/24/09

Lioté H et al. – Knowledge of these presentations of rituximab–induced lung disease should prove helpful for diagnosis and causality assessment purposes. Time–to–onset data, suggesting different pathogenic mechanisms, support closer clinical and perhaps radiological monitoring between infusions, particularly in patients with a history of reversible respiratory symptoms.

Exclusive Author Commentary
H. Lioté, 07/25/09

After haematological conditions, rituximab (RTX) is increasingly used even in autoimmune diseases and in transplantation, and the number of reported RTX-related lung side-effects is also increasing. These hyperacute, acute or chronic RTX-induced lung diseases should be clearly known from RTX users, namely haematologists, oncologists, and internal medicine subspecialists such as rheumatologists. Importantly the most frequent pattern is an acute lung disease occurring 2 weeks after the last RTX infusion, related histologically to an organizing pneumonia, and improved with early steroid therapy. Anyway such a drug-related pneumonitis remains after excluding other causes: operational procedures for causality assessment are mandatory.

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