|
?:abstract
|
-
Introduction: Serum sickness, an immune-complex-mediated hypersensitivity reaction, is more common in adults than children Rituximab has been reported as an agent that can cause serum sickness This case discusses a pediatric patient who developed rituximab-induced serum sickness in the setting of a positive history of COVID-19 and recently diagnosed neuromyelitis optica, celiac disease, immune thrombocytopenia, and Sjogren’s syndrome Case Description: Our patient is a previously healthy 10-year-old female who contracted COVID-19 without complications, and two months later developed eye pain with decreased vision, weakness, fatigue, urinary retention, and poor appetite with weight loss She was diagnosed with celiac disease and neuromyelitis optica She received pulse steroids, plasmapheresis, and rituximab Twelve days after her first dose of rituximab, and prior to the second dose, she developed fever and a diffuse nonpruritic erythematous rash, which worsened during the second dose She also had transient polyarthralgia Laboratory findings demonstrated leukopenia with neutropenia and lymphopenia, thrombocytopenia, elevated CRP, elevated liver enzymes, positive anti-SS-A, and elevated C4 level A diagnosis of rituximab-induced serum sickness was made She improved with cessation of rituximab and treatment with antihistamines and steroids Discussion: This patient\'s presentation of rituximab-induced serum sickness in the setting of multiple autoimmune disorders is notable, particularly given her age and COVID-19 history Rituximab-induced serum sickness has been shown to be more frequent in patients with autoimmune diseases It is unknown if her COVID-19 history is directly relevant to her overall clinical picture, but it is important to mention given reports of COVID-19 leading to autoimmune and autoinflammatory diseases in children
|
![[This page as RDF]](https://research.tib.eu/covid-19/static/rdf-icon.gif){kind=icon}