Rituximab induced acute respiratory distress syndrome (ARDS) reversed with plasmapheresis: case report

Abstract

Rituximab is a chimeric Anti-CD20 anti-body initially used in the treatment of non-Hodgkin´s B-cell lymphoma. Currently, the field of use has become wider, despite the results in terms of therapeutic efficiency, rituximab has been implicated in numerous adverse events, we´re here to report the case of a female patient with post-viral C cryoglobulinemia who developed ARDS following rituximab infusion. A 69-year-old female patient was admitted to the intensive care unit for respiratory distress. In her antecedents we find a viral hepatitis C treated 10 years ago complicated by cryoglobulinemia, put on anti-CD20, which last cure was 5 days before her admission to the hospital. The patient developed ARDS in the aftermath of her hospitalization where the causality was linked to the Rituximab cure after eliminating the other causes, the patient was treated with different levels of treatment including plasmapheresis, which showed encouraging results, however unfortunately this was not enough to save the patient. Considering the rarity of this clinical picture and consequently the therapeutic approaches, plasmapheresis probably appears an important pillar in the therapeutic arsenal of this entity.