Skip to main content

Advertisement

SpringerLink
Log in

Rituximab for refractory eosinophilic fasciitis: a case series with long-term follow-up and literature review

  • Cases with a Message
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Key message

RTX could be an effective and safe alternative treatment for refractory EF.

Abstract

Rituximab (RTX) is a successful therapeutic option for various autoimmune diseases. Our aim is to report our experience with RTX in eosinophilic fasciitis (EF) and review published data on its efficacy for the treatment of EF. We reviewed the medical charts of all patients with a diagnosis of EF treated with RTX from 2008 to 2020 in the Department of Rheumatology and Clinical Immunology in the University Hospital of Heraklion, Crete, Greece. We also reviewed the English literature for cases of EF treated with RTX. Demographics, clinical manifestations, laboratory findings, prior treatments, response to RTX, cumulative RTX dose, duration of treatment and follow-up are reported. We report three cases of EF refractory to conventional DMARDs (cDMARDs) that responded to RTX. Furthermore, literature review revealed five cases. In our case series in all patients, RTX was the first biologic. RTX could be effective in cases of (EF) refractory to standard immunosuppressive treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Shulman LE (1974) Diffuse fasciitis with hypergammaglobulinemia and eosinophilia: a new syndrome? J Rheumatol 1(suppl 1):46–49

    Google Scholar 

  2. Baumann F, Brühlmann P, Andreisek G, Michel BA, Marincek B, Weishaupt D (2005) MRI for diagnosis and monitoring of patients with eosinophilic fasciitis. AJR Am J Roentgenol 184:169–174. https://doi.org/10.2214/ajr.184.1.01840169

    Article  PubMed  Google Scholar 

  3. Lakhanpal S, Ginsburg WW, Michet CJ, Doyle JA, Moore SB (1988) Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum 17:221–31

    Article  CAS  PubMed  Google Scholar 

  4. Scheinberg M, Hamerschlak N, Kutner JM, Ribeiro AA, Ferreira E, Goldenberg J, Kiss MH, Cjahade WH (2006) Rituximab in refractory autoimmune diseases: Brazlian experience with 29 patients. Clin Exp Rheumatol 24:65–9

    CAS  PubMed  Google Scholar 

  5. De Masson A, Bouaziz JD, Peffault de Latour R, Benhamou Y, Moluçon-Chabrot C, Bay JO, Laquerrière A, Picquenot JM, Michonneau D, Leguy-Seguin V, et al (2013) Severe aplastic anemia associated with eosinophilic fasciitis. Medicine 92:69–81. https://doi.org/10.1097/md.0b013e3182899e78

    Article  PubMed  PubMed Central  Google Scholar 

  6. Thomson G, Johnston JL, Thomson BRJ (2015) Eosinophilic fasciitis treated with tocilizumab: demonstration of efficacy after withdrawal and re-challenge in a patient. J Rheum Dis Treat 1:1–3

    Article  Google Scholar 

  7. Chan WH, Lewis DJ, Kim EJ, Aung PP, Duvic M (2018) Generalized morphea/eosinophilic fasciitis overlap after epoxy exposure. JAAD Case Rep 4(2):175–178. https://doi.org/10.1016/j.jdcr.2017.09.006

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nahhas AF, Alam M, Lim HW (2018) Rituximab as a therapeutic consideration for refractory eosinophilic fasciitis. Int J Dermatol 57(5):614–615. https://doi.org/10.1111/ijd.13940

    Article  PubMed  Google Scholar 

  9. Lebeaux D, Francès C, Barete S, Wechsler B, Dubourg O, Renoux J, Maisonobe T, Benveniste O, Gatfossé M, Bourgeois P et al (2012) Eosinophilic fasciitis (Shulman disease): new insights into the therapeutic management from a series of 34 patients. Rheumatol (Oxf) 51(3):557–561. https://doi.org/10.1093/rheumatology/ker366

    Article  CAS  Google Scholar 

  10. Perosa F, Prete M, Racanelli V, Dammacco Fl (2010) CD20-depleting therapy in autoimmune diseases: from basic research to the clinic. J Intern Med 267:260–77. https://doi.org/10.1111/j.1365-2796.2009.02207.x

    Article  CAS  PubMed  Google Scholar 

  11. Jordan S, Distler JH, Maurer B, Huscher D, van Laar JM, Allanore Y on behalf of the EUSTAR Rituximab study group (2015) Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group. Ann Rheumat Dis 74:1188–1194. https://doi.org/10.1136/annrheumdis-2013-204522

    Article  CAS  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Heraklion, Greece

    Nikolaos Kougkas, George Bertsias, Ioannis Papalopoulos, Argiro Repa, Prodromos Sidiropoulos & Nestor Avgoustidis

Authors
  1. Nikolaos Kougkas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. George Bertsias
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ioannis Papalopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Argiro Repa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Prodromos Sidiropoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nestor Avgoustidis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nikolaos Kougkas.

Ethics declarations

Conflict of interest

None.

Patient consent

Written informed consent for the publication of this report was obtained from all patients by the corresponding author.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kougkas, N., Bertsias, G., Papalopoulos, I. et al. Rituximab for refractory eosinophilic fasciitis: a case series with long-term follow-up and literature review. Rheumatol Int 41, 1833–1837 (2021). https://doi.org/10.1007/s00296-021-04887-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-021-04887-3

Keywords

Search

Navigation