Profound symptomatic hypogammaglobulinemia: a rare late complication after rituximab treatment for immune thrombocytopenia. Report of 3 cases and systematic review of the literature

Romain Levy, Matthieu Mahévas, Lionel Galicier, David Boutboul, Julien Moroch, Valentine Loustau, Constance Guillaud, Laeticia Languille, Olivier Fain, Philippe Bierling, Medhi Khellaf, Marc Michel, Eric Oksenhendler, Bertrand Godeau

Index: Autoimmun. Rev. 13(10) , 1055-63, (2014)

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Abstract

Introduction B-cell depletion with rituximab (RTX) is widely used to treat autoimmune diseases, especially as second-line therapy for immune thrombocytopenia (ITP). The incidence of RTX-induced hypogammaglobulinemia is unknown because of heterogeneous follow-up and confounding factors such as concomitant immunosuppressive treatments in most patients. We describe 3 cases and attempted to determine the incidence of RTX-induced hypogammaglobulinemia by a systematic review of the literature.