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Polymyositis and pemphigus vulgaris in a patient: Successful treatment with rituximab
Joint, Bone, Spine, 11/07/08

Tournadre A et al. - Rituximab may be a good alternative to immunosuppressive drugs in polymyositis and pemphigus especially in lymphoma-risk patients. However, it did not prevent progression to secondary amyloidosis.

• Study reports a case of antisynthetase syndrome with a history of EBV-induced lymphoma which developed pemphigus vulgaris
• Rituximab was effective both on polymyositis and on pemphigus
• 15 mos later, the patient died from a septic shock after the first cyclophosphamide infusion for amyloidosis while the B cell population remained depleted
• Fatal infection developed in this patient raises the question of whether a prolonged B cell depletion with rituximab contributes to a greater risk of infection

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