• Internal medicine · Jul 2024

    Late-onset Neutropenia after Rituximab Treatment for MPO-ANCA-associated Vasculitis.

    • Kentaro Watanabe, Noriaki Shimada, Motoko Kanzaki, Kosuke Fukuoka, and Kenichiro Asano.
    • Department of Nephrology, Kurashiki Central Hospital, Japan.
    • Intern. Med. 2024 Jul 18.

    AbstractAn underestimated side effect of rituximab is late-onset neutropenia (R-LON), which often resolves spontaneously and rarely results in a severe infection. We herein report a case of febrile neutropenia due to R-LON in a 91-year-old woman with renal failure who was treated with rituximab to induce remission of MPO-ANCA-associated vasculitis. Fifty-four days after the last rituximab administration, the patient was hospitalized for febrile neutropenia due to R-LON, which improved with granulocyte colony-stimulating factor and antibiotics. Although R-LON may resolve spontaneously and remain unnoticed, it can cause severe infections in the elderly and patients with renal failure.

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