Abdullah TURASAN, Osman YOKUŞ, Özlem BALÇIK ŞAHİN, Murat ALBAYRAK, Burak UZ

Rituximab-induced serum sickness in a patient with refractory chronic immune thrombocytopenic purpura: a case report and review of the literature

Ateş, titreme ve kasılma gibi yan etkiler ilk kez yapılan rituksimab infüzyonu sırasında sıkçagörülmesine karşılık, serum hastalığı ve Steven-Johnson sendromu gibi gecikmiş yan etkiler nadirolarak bildirilmiştir. Steroide dirençli ve splenektomize kronik immün trombositopenili bir hasta,üçüncü rituksimab infüzyonundan iki gün sonra ateş, artralji, astım benzeri solunum sistemisemptomları, makülopapüler raş ve palpabl purpurik lezyonlar ile başvurdu. Rituksimabınkesilmesi, sonrasında intravenöz steroid ve antihistaminik tedavi uygulanması ile hastanın kliniğive fiziki bulguları düzeldi. Bu gibi vakalarda rituksimabın kesilmesi ve sistemik steroid tedaviuygulanması ile tam ve hızlı bir düzelme sağlanabileceğini düşünmekteyiz.

Ref rakter kronik immün trombositop enili bir hastada rituksimab ilişkili serum hastalığı: bir vaka rap oru ve literatürün gözden geçirilmesi

Although common side effects such as fever, chills and rigors are commonly seen during the firstinfusion of rituximab; delayed ones such as serum sickness and Steven-Johnson syndrome haverarely been reported. We report an adult patient with steroid resistant and splenectomized chronicimmune thrombocytopenic purpura who presented with fever, arthralgia, asthma like respiratorysymptoms, maculopapular rash, and palpable purpuric lesions 2 days after the third infusion ofrituximab. Withdrawal of rituximab and subsequent treatment with i.v. steroid and antihistaminicsimproved the patient s clinical and physical findings. In such cases rituximab should bediscontinued, complete and rapid resolution can be possible with systemic steroid treatment.

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