DOUZE Makenzi, Vintila Sabina, Klipper Dit Kurtz Noemie, Makhoul Martin and MOND Victoria

Rituximab (RTX) is a mouse/human chimeric anti-CD20 IgG1 monoclonal antibody, approved in late 1998 by the FDA. Effectively used as a single agent or combined with a chemotherapy regimen to treat lymphoma, RTX is a significant step forward in the arsenal treatment of idiopathic thrombocytopenic purpura, systemic lupus erythematous, rheumatoid arthritis, and autoimmune hemolytic anemia. (1-2-3-4). Side effects of RTX are commonly seen during the first infusion in up to 50% of patients and include fever, chills, and rigors. These side effects are generally transient and related to the tumor burden, probably due to a greater degree of complement activation and proinflammatory cytokine release. (5-6-7-8). Severe lung toxicity like cryptogenic organizing pneumonia, pneumonitis, and interstitial lung diseases are infrequent, with most of the knowledge coming from case reports. The objective of this article is to peculiarize the syndrome of rituximab-induced interstitial lung disease (R-ILD). We proposed a thorough description of R-ILD, based on information’s gathered from reported cases and the medical literature reviews. Our emphasis will be on patients’ characteristics, treatment options, clinical presentation, risks factors, imaging studies, and pulmonary function tests (PFTs); Standard and new diagnostic procedure such Transbronchial Pulmonary Cryobiopsy (TPC) will also be discussed. In a practical manner, we propose to do so by presenting two such cases.

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