Long-term efficacy of rituximab in hepatitis C virus-associated cryoglobulinemia

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Pereira, Patrícia da Silva Fucuta [UNIFESP]
Lemos, Lara Barros [UNIFESP]
Oliveira Uehara, Silvia Naomi de [UNIFESP]
Souza e Silva, Ivonete Sandra de [UNIFESP]
Benedito Silva, Antonio Eduardo [UNIFESP]
Ferraz, Maria Lucia Cardoso Gomes [UNIFESP]
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Mixed cryoglobulinemia is one of the most closely related extrahepatic manifestations of hepatitis C virus and requires a challenging therapeutic approach depending on the severity of the symptoms. Here, we describe the long-term follow-up of a patient with important cutaneous, articular and neural manifestations of cryoglobulinemia associated with chronic hepatitis C treated with rituximab. A 42-year-old woman who did not respond to previous interferon-based treatments (standard and pegylated interferon plus ribavirin) and corticosteroids was subjected to treatment with rituximab at a dose of 375 mg/mA(2) per week for 4 consecutive weeks. the drug was well tolerated and complete improvement of arthralgia was immediately evident. There was gradual improvement of lower limbs paresthesia and healing of a leg ulcer that had been active for 5 years. the clinical and immunological responses induced by rituximab are sustained over long-term follow-up, and this case illustrates the drug efficacy for non-responder patients to antiviral therapy.
Rheumatology International. Heidelberg: Springer Heidelberg, v. 30, n. 11, p. 1515-1518, 2010.