Severe Arboviral Neuroinvasive Disease in Patients on Rituximab Therapy: A Review
With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Cen...
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| Vydáno v: | Clinical infectious diseases Ročník 76; číslo 6; s. 1142 |
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| Hlavní autoři: | , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
21.03.2023
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| ISSN: | 1537-6591, 1537-6591 |
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| Abstract | With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days to 1 year), and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be counseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies. |
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| AbstractList | With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days to 1 year), and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be counseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies. With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days to 1 year), and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be counseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies.With increasing use of rituximab and other B-cell depleting monoclonal antibodies for multiple indications, infectious complications are being recognized. We summarize clinical findings of patients on rituximab with arboviral diseases identified through literature review or consultation with the Centers for Disease Control and Prevention. We identified 21 patients on recent rituximab therapy who were diagnosed with an arboviral disease caused by West Nile, tick-borne encephalitis, eastern equine encephalitis, Cache Valley, Jamestown Canyon, and Powassan viruses. All reported patients had neuroinvasive disease. The diagnosis of arboviral infection required molecular testing in 20 (95%) patients. Median illness duration was 36 days (range, 12 days to 1 year), and 15/19 (79%) patients died from their illness. Patients on rituximab with arboviral disease can have a severe or prolonged course with an absence of serologic response. Patients should be counseled about mosquito and tick bite prevention when receiving rituximab and other B-cell depleting therapies. |
| Author | Khan, Ezza Velez, Jason O Brault, Aaron Gill, Christine M Fischer, Marc Gould, Carolyn V Hughes, Holly R Pastula, Daniel M Panella, Amanda Kapadia, Ronak K Laven, Janeen J Staples, J Erin |
| Author_xml | – sequence: 1 givenname: Ronak K surname: Kapadia fullname: Kapadia, Ronak K organization: Division of Neurology, Department of Clinical Neurosciences, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada – sequence: 2 givenname: J Erin surname: Staples fullname: Staples, J Erin organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 3 givenname: Christine M surname: Gill fullname: Gill, Christine M organization: University of Iowa, Carver College of Medicine, Department of Neurology, Iowa City, Iowa, USA – sequence: 4 givenname: Marc surname: Fischer fullname: Fischer, Marc organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 5 givenname: Ezza surname: Khan fullname: Khan, Ezza organization: Hunterdon Infectious Disease Specialists, Flemington, New Jersey, USA – sequence: 6 givenname: Janeen J surname: Laven fullname: Laven, Janeen J organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 7 givenname: Amanda surname: Panella fullname: Panella, Amanda organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 8 givenname: Jason O surname: Velez fullname: Velez, Jason O organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 9 givenname: Holly R surname: Hughes fullname: Hughes, Holly R organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 10 givenname: Aaron surname: Brault fullname: Brault, Aaron organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA – sequence: 11 givenname: Daniel M surname: Pastula fullname: Pastula, Daniel M organization: Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA – sequence: 12 givenname: Carolyn V surname: Gould fullname: Gould, Carolyn V organization: Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA |
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| SubjectTerms | Animals Arbovirus Infections Disease Outbreaks Encephalitis, Tick-Borne - epidemiology Rituximab - therapeutic use West Nile Fever - complications West Nile Fever - drug therapy West Nile Fever - epidemiology |
| Title | Severe Arboviral Neuroinvasive Disease in Patients on Rituximab Therapy: A Review |
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