Rituximab For Remission In Relapsing Anca Negative Retro Orbital Wegener’s Granulomatosis

Abstract

We present a follow-up on a previously published case of a 59 year-old female diagnosed with ANCA negative limited Wegener’s Granulomatosis(WG ) of the right orbit with history of Graves ’ disease who presented with exophthalmos. Despite treatment with steroids and cyclophosphamide, patient had a relapse while steroids were being tapered. She was then treated with IV Rituximab with remission and resolution of her symptoms. She is currently doing well on maintenance therapy with methotrexate. Rituximab is a monoclonal anti-CD20 antibody effective in treatment of ANCA associated vasculitis including systemic WG. Our case shows Rituximab may be a therapeutic option in the treatment of ANCA negative retro orbital WG in patients who failed treatment with cyclophosphamide.