Wegener's Granulomatosis Presenting with Pachymeningitis: Clinical and Imaging Remission by Rituximab

Table 1

Clinical characteristics and outcomes in previous cases of Wegener’s meningitis treated with Rituximab.

Reference	Patient	Previous therapy	Treatment protocol		Followup (mo)	Time to relapse (mo)	Rituximab cycles	Outcome
Bawa et al. 2007 [7]	Female; 36 years	CYC pulse and GC pulse	First day: Rituximab; (1 g. iv.); Methylprednisolone (250 mg iv.)	Second day: Cyclophosphamide (750 mg iv.)Regime repeated once 2 weeks later.	6	No relapse	1	Complete clinical remission, MRI findings persistent.
Tamura et al. 2007 [8]	Female; 19 years	CYC pulse, GC oral, and MTX	Rituximab (375 mg/m^2) weekly in four weeks	Prednisolone 100 mg/day gradually tapered	12	9	2	BVAS (19→2)
Tamura et al. 2007 [8]	Female; 35 years	CYC pulse, GC oral and pulse, and MTX/CSA	Rituximab (375 mg/m^2) weekly in four weeks	Prednisolone 50 mg/day gradually tapered	5	No relapse	1	BVAS (13→3)
Henes et al. 2007 [9]	Male; 45 years	CYC oral and pulse, GC oral, and INF	Rituximab (375 mg/m^2) weekly in four weeks	Prednisolone 1 mg/kg/day gradually tapered. Leflunomide 20 mg/day	21	18	2	Some clinical and MRI improvement.
Sharma et al 2010 [10]	Female; 22 years	GC oral and pulse, MTX, and CYC pulse	Rituximab (375 mg/m^2) weekly in four weeks	Prednisolone 60 mg/day gradually tapered.	6	6	2	Clinical remissionMRI not described
Presented case	Female; 28 years	CYC oral and pulse, GC oral, MTX, and AZA	Rituximab (375 mg/m^2) weekly in four weeks	On separate day in each week: Methylprednisolone (250 mg iv.) Cyclophosphamide (500 mg/m^2 iv.)	30	9	4	Complete clinical and MRI remission

BVAS: Birmingham vasculitis activity score modified for WG, CYC: Cyclophosphamide, GC: Glucocorticosteroids, MTX: Methotrexate, CSA: Cyclosporine A, INF: Infliximab, AZA: Azathioprine. Iv.: intravenous.