ArticleNeurology(R) neuroimmunology & neuroinflammation2020
Single-cycle rituximab-induced immunologic changes in children: Enhanced in neuroimmunologic disease?
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- Detecting space-time clusters of COVID-19 in Brazil: mortality, inequality, socioeconomic vulnerability, and the relative risk of the disease in Brazilian municipalities.Journal of geographical systems · 2021Article
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13 authors at 1 institution in 1 country.
Angela Deyà-MartínezFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Yadira GordónFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.ORCID 0000-0001-9824-7850
Cristina Molina-AnguitaFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Alexandru VlageaFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Monica PiquerFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Manel JuanFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.ORCID 0000-0002-3064-1648
Ana Esteve-SoléFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Jordi AntónFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Álvaro MadridFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.ORCID 0000-0002-5942-8488
Ana García-GarcíaFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Ana M PlazaFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain.
Thaís ArmangueFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain. lalsina@sjdhospitalbarcelona.org armangue@clinic.cat.
Laia AlsinaFrom the Clinical Immunology and Primary Immunodeficiencies Unit (A.D.-M., A.E.-S., A.G.-G., L.A.), Pediatric Allergy and Clinical Immunology Department (A.D.-M., Y.G., M.P., A.E.-S., A.G.-G., A.M.P., L.A.), Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu (A.D.-M., Y.G., M.P., A.E.-S., J.A., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Clinical Immunology Unit Hospital Sant Joan de Déu-Hospital Clínic (A.D.-M., A.V., M.P., M.J., A.E.-S., A.G.-G., A.M.P., L.A.), Barcelona, Spain; Universitat de Barcelona (J.A., L.A., M.J.), Spain; Immunology Department (A.V., M.J.), Biomedical Diagnostics Center, Hospital Clinic-IDIBAPS, Barcelona, Spain; Pediatric Neuroimmunology Unit (C.M.-A., T.A.), Neurology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain; Neuroimmunology Program (T.A.), Institut D'Investigacions Biomèdiques (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain; Pediatric Rheumatology Division (J.A.), Hospital Sant Joan de Déu, Barcelona, Spain; and Pediatric Nephrology Department (Á.M.), Hospital Sant Joan de Déu, Barcelona, Spain. lalsina@sjdhospitalbarcelona.org armangue@clinic.cat.ORCID 0000-0002-3559-0018
Hospital Sant Joan de Déu Barcelona · ES
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the immunologic impact of a single cycle of rituximab (RTX) in children and adolescents with immune-mediated disorders, we evaluated B cells and immunoglobulin levels of 20 patients with neuroimmunologic, nephrologic, dermatologic, and rheumatologic disorders treated under recommended guidelines.
methodsRetrospective study of immunologic changes in children (aged ≤18 years) diagnosed with immune-mediated disorders in which RTX was prescribed between June 2014 and February 2019. Patients were excluded if they had prior diagnosis of malignant disease or primary immunodeficiency. Patients were clinically and immunologically followed up every 3 months. Only patients having received a single cycle of RTX and with a follow-up greater than 12 months were included in the analysis of persistent dysgammaglobulinemia.
resultsTwenty children were included. Median age at RTX treatment was 12.8 years (interquartile range [IQR] 6.6-15.5 years). Median follow-up was 12.6 months (IQR 10.2-24 months). Of the 14 patients eligible for persistent dysgammaglobulinemia analysis (3 had received RTX retreatment, 2 had <12 months post-RTX follow-up, and in 1 data for this time point was missing), 2/14 (14%) remained with complete B-cell depletion, and 5/14 (36%) had dysgammaglobulinemia. Patients with dysgammaglobulinemia were younger (7.8 vs 15.6 years,
conclusionIn our cohort, single-cycle RTX-induced dysgammaglobulinemia was enhanced in patients with neuroimmunologic diseases. Further studies are needed to confirm this observation.
Indexed as
AdolescentB-LymphocytesChildChild, PreschoolDysgammaglobulinemiaFemaleFollow-Up StudiesHumansImmune System DiseasesImmunologic FactorsMaleRetrospective StudiesRituximabImmunologic FactorsRituximab
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