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Case Report
 

Successful Use of Rituximab in Refractory Idiopathic Thrombocytopenic Purpura in a Patient With Common Variable Immunodeficiency
 

M Al-Ahmad,1 M Al-Rasheed,2 A Al-Muhani2

1Department of Allergy, Al-Rashed Allergy center, Ministry of Health, Kuwait
2Department of Medicine, Mubarak Hospital, Ministry of Health, Kuwait

J Investig Allergol Clin Immunol 2010; Vol. 20(3): 259-262
 

 Abstract


Idiopathic thrombocytopenic purpura (ITP) is a common autoimmune disease in patients with common variable immunodeficiency (CVID). We describe a 36-year-old woman with CVID. The clinical course of her disease was complicated by bronchiectasis, antiphospholipid antibody syndrome, and portal vein thrombosis. She developed recurrent attacks of ITP refractory to high doses of corticosteroid, intravenous
immunoglobulin (IVIG), and splenectomy. She received a total of 5 doses of rituximab (375 mg/m2) and achieved an immediate and persistent response. Therapy was well tolerated. Her platelet count remained above 370 000/μL for 8 months of follow-up, despite repeated infections. During this period the patient remained off corticosteroids and on continuous IVIG replacement therapy.

Key words: Rituximab. Idiopathic thrombocytopenic purpura. Common variable immunodeficiency.