One patient with Graves' hyperthyroidism and ophthalmopathy in its active phase and unresponsive to steroid, was treated with the anti-CD20 monoclonal antibody, rituximab (RTX), as part of an open study. The effect of RTX in the thyroid and the orbital tissues was studied. The ophthalmopathy responded to RTX therapy by ameliorating the eye signs with a decrease in the clin. activity score from 5 to 2 in 3 mo, while the patient had peripheral B-cell depletion. Hyperthyroidism did not improve during the 6 mo of B-cell depletion and serum TSH-receptor antibodies (TRAb) levels did not significantly change after RTX therapy. Therefore, the patient underwent total thyroidectomy and few B-cells were found in the thyroid tissue specimens. While the patient eye disease remained stable (clin. activity score= 2), we performed corrective orbital decompression and we found absence of lymphocytes in the orbital tissue specimens. We believe that RTX treatment in Graves' disease may cause amelioration of ophthalmopathy by depleting total lymphocytes population in the orbit. The persistence of Graves' hyperthyroidism suggests that a single cycle of RTX does not result in complete lymphocyte depletion in thyroid tissue and thus no decline in serum TRAb was observed.
Efficacy of rituximab treatment for thyroid-associated ophthalmopathy as a result of intraorbital B-cell depletion in one patient unresponsive to steroid immunosuppression / M. Salvi, G. Vannucchi, I.Campi, S. Rossi, P. Bonara, F. Sbrozzi, C. Guastella, S. Avignone, G. Pirola, R. Ratiglia, P. Beck Peccoz. - In: EUROPEAN JOURNAL OF ENDOCRINOLOGY. - ISSN 0804-4643. - 154:4(2006), pp. 511-517.
|Titolo:||Efficacy of rituximab treatment for thyroid-associated ophthalmopathy as a result of intraorbital B-cell depletion in one patient unresponsive to steroid immunosuppression|
VANNUCCHI, GUIA MARIA (Secondo)
RATIGLIA, ROBERTO (Penultimo)
BECK PECCOZ, PAOLO LUIGI MARIA (Ultimo)
|Parole Chiave:||Eye ; Graves' disease ; Graves' ophthalmopathy ; rituximab treatment for thyroid-assocd. ophthalmopathy results in intraorbital B-cell depletion in one patient unresponsive to steroid immunosuppression ; Antibodies and Immunoglobulins Role ; PAC (Pharmacological activity) ; THU (Therapeutic use) ; BIOL (Biological study), USES (Uses) ; monoclonal ; Antithyroid agents ; B cell ; Human ; Hyperthyroidism CD20 ; Thyrotropin receptors Role: BSU (Biological study, unclassified), BIOL (Biological study)|
|Settore Scientifico Disciplinare:||Settore MED/30 - Malattie Apparato Visivo|
|Data di pubblicazione:||2006|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1530/eje.1.02119|
|Appare nelle tipologie:||01 - Articolo su periodico|