Pancytopenia following rituximab therapy in a patient with rheumatoid arthritis: Could filgrastim be a temporary solution?

Authors

  • Robin George Manappallil Consultant – Physician, Department of Medicine, National Hospital, Calicut, Kerala 673009, India

DOI:

https://doi.org/10.3126/ajms.v7i5.14679

Keywords:

Pancytopenia, Rituximab, Filgrastim, Rheumatoid arthritis

Abstract

Rheumatoid  arthritis  is  a  chronic  inflammatory  disease  affecting  the  peripheral  joints  and  can  also  have  extraarticular  manifestations.  The  introduction  of  biological agents  have  opened  new  windows  to  the  treatment  of  rheumatoid  arthritis.  Rituximab  is  a  monoclonal  antibody  directed  against  CD20  cells,  thereby  reducing  the  inflammation.  There  have  been  reports  of  neutropenia,  but  pancytopenia  is  an  uncommon  incident.  Filgrastim, a  human  granulocyte  colony  stimulating  factor,  can  stimulate  neutrophil  production.  The  patient  being  described  is  a  case  of  rheumatoid  arthritis,  who  developed  severe  pancytopenia  following  rituximab  therapy.  She  was  given  filgrastim  injections,  which  temporarily  normalized  her  leucopenia  and  neutropenia.  This  report  emphasizes  the  possibility  of  developing  pancytopenia  following  rituximab  injection  and  the  need  of  regular  follow  up  of  complete  blood  counts.  In  such  cases,  filgrastim  may  be  a  temporary  solution. Also  special  consideration  should  be  given  to  the  increased  risk  of  infections  after  taking  rituximab.

Asian Journal of Medical Sciences Vol.7(5) 2016 138-141

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Author Biography

Robin George Manappallil, Consultant – Physician, Department of Medicine, National Hospital, Calicut, Kerala 673009, India

Consultant - Physician,

Department of Medicine

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Published

2016-08-31

How to Cite

Manappallil, R. G. (2016). Pancytopenia following rituximab therapy in a patient with rheumatoid arthritis: Could filgrastim be a temporary solution?. Asian Journal of Medical Sciences, 7(5), 138–141. https://doi.org/10.3126/ajms.v7i5.14679

Issue

Vol. 7 No. 5 (2016)

Section

Case Reports

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