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Case Reports in Rheumatology
Volume 2016, Article ID 7275860, 3 pages
http://dx.doi.org/10.1155/2016/7275860
Case Report

A Case of Rituximab Use as an Induction and Maintenance of Remission in ANCA-Associated Vasculitis

1Department of Internal Medicine, Medical College, Umm-Al Qura University, Makkah, Saudi Arabia
2Department of Internal Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
3Alzaidi Chair of Research in Rheumatic Disease, Umm-Al Qura University, Makkah, Saudi Arabia

Received 16 December 2015; Accepted 8 February 2016

Academic Editor: Mario Salazar-Paramo

Copyright © 2016 Neveen Awad et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) is a multisystem autoimmune disease affecting mainly microscopic blood vessels due to circulating autoantibodies against neutrophil cytoplasmic antigens. We report a case of a 57-year-old female patient presenting with hemoptysis, sinusitis, and conjunctivitis. Based on lung biopsy, the diagnosis of antineutrophil cytoplasmic antibody- (ANCA-) associated vasculitis (AAV) was established. She was put on rituximab as induction and maintenance therapy. She responded initially to rituximab as induction therapy but failed to respond in the maintenance course of the drug. Rituximab was stopped and mycophenolate mofetil was administered. She responded as laboratory c-ANCA titers turned negative and symptoms subsided. There are no randomized clinical trials addressing rituximab effect in induction and remission at the same time. This case report doubts the efficacy of the use of rituximab therapy for both induction and maintenance of remission at the same time, waiting for the results of the ongoing trials.