Safety and efficacy of rituximab treatment for vasculitis in hepatitis B virus-associated type II cryoglobulinemia: a case report

• Published in: Journal of medical case reports Vol. 6; no. 1; p. 39
• Main Authors: Pasquet, Florian, Combarnous, François, Macgregor, Brigitte, Coppere, Brigitte, Mausservey, Christelle, Ninet, Jacques, Hot, Arnaud
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 27.01.2012; BioMed Central; BMC
• Subjects: Care and treatment; Case Report; Complications and side effects; Cryoglobulinemia; Drug therapy; Hepatitis B; Patient outcomes; Risk factors; Vasculitis
• ISSN: 1752-1947; 1752-1947
• DOI: 10.1186/1752-1947-6-39

Systemic B-cell depletion and clinical remission of the systemic effects of cryoglobulins have already been achieved using rituximab in hepatitis C virus-positive immunocompetent patients. Conversely, to the best of our knowledge there are no reports in the literature regarding the use of rituximab in hepatitis B virus-associated cryoglobulinemia. We report here the case of a 60-year-old Caucasian man who presented with hepatitis B virus-associated type II cryoglobulinemia with severe multisystem disease, including membranoproliferative glomerulonephritis with acute renal failure. The vasculitis was refractory to conventional and antiviral therapy but rituximab use led to a fall in cryoglobulin levels and disease control. The B-cell depletion was safe and efficient to induce a complete remission of the disease. Our case highlights the benefit and the efficacy of rituximab in association with antiviral therapy in small vessel vasculitis related to hepatitis B virus-associated mixed cryoglobulinemia.