Rituximab treatment in a case of anti- synthetase syndrome with severe interstitial lung disease and acute respiratory failure

Maria Cristina Zappa; Tiziana Trequattrini; Francesco Mattioli; Rosario Rivitti; Rossana Vigliarolo; Antonella Marcoccia; Giovanni D’Arcangelo

doi:10.4081/mrm.2011.439

Rituximab treatment in a case of anti- synthetase syndrome with severe interstitial lung disease and acute respiratory failure

Authors

Maria Cristina Zappa Division of Lung Disease, Sandro Pertini Hospital, Rome
Tiziana Trequattrini Division of Lung Disease, Sandro Pertini Hospital, Rome
Francesco Mattioli Division of Lung Disease, Sandro Pertini Hospital, Rome
Rosario Rivitti Division of Lung Disease, Sandro Pertini Hospital, Rome
Rossana Vigliarolo Division of Lung Disease, Sandro Pertini Hospital, Rome
Antonella Marcoccia Division of Angiolology, Sandro Pertini Hospital, Rome
Giovanni D’Arcangelo Division of Radiology, Sandro Pertini Hospital, Rome

DOI: https://doi.org/10.4081/mrm.2011.439

Keywords:

Acute respiratory failure, immunology, interstitial lung disease, rituximab

Abstract

We present a case of severe interstitial pneumonitis, mild polyarthritis and polymyositis, and Raynaud's syndrome with the presence of anti-Jo-1 antibodies, which had been diag- nosed as anti-synthetase syndrome. The presence, however, of anti-Ro/SSA antibodies led us to understand that we were dealing here with a more severe form of interstitial lung dis- ease. The patient was treated for acute respiratory failure but he showed resistance to glucocorticoids and cyclosporine. Thus, he was treated with infusions of anti-CD20 therapy (rituximab): his clinical conditions improved very rapidly and a significant decrease in the activity of pulmonary disease was detected using high-resolution computerized tomogra- phy (HRCT) of the thorax and pulmonary function tests.