Infective endocarditis complicating rituximab in a lupus patient with lupus nephritis and dilated cardiomyopathy: case report and review of literature

Abstract

BackgroundSystemic lupus erythematosus is a chronic multisystem disease that has a considerable morbidity and mortality. Rituximab is used in treating some severe manifestations of systemic lupus erythematosus; however, it may expose patients to serious infections. We report a case of post rituximab infective endocarditis as the second case in literature described in patients with SLE.Case presentationA 17-year-old male diagnosed as systemic lupus erythematosus with lupus nephritis and dilated cardiomyopathy received rituximab and underwent upper endoscopy and colonoscopy investigating iron deficiency anemia. Later on the patient developed septic shock secondary to infective endocarditis and passed away.ConclusionsInfective endocarditis is a possible complication after rituximab therapy in lupus patients with lupus nephritis and dilated cardiomyopathy. Prophylactic antibiotics may be considered in those patients in the settings of gastrointestinal endoscopies.