Has anyone needed IV IgG treatment after Rituxan treatment?
For a few years after stopping Rituxan, I was sick all the time - mostly severe respiratory infections. Every year I got flu in spite of flu vaccine, odd intestinal infections. Was sent to a pulmonologist for respiratory issues who did bunches of immunological tests. Found Rituxan completely wiped out B cells. I still have no B cells. As a result do not make immunoglobulins. Am low on IgG and IgM. Now have to get IV IgG every four weeks for rest of life to stay healthy. Works like a charm but was never warned this was a risk. Anyone else with similar experience? Have never seen this in any RA forum
Hi seaberry. Sorry to hear you have this B cell destruction issue. Like you, I have not seen this mentioned in this community or elsewhere. That certainly doesn't mean others are not out there with this issue and hopefully anyone familiar with it will chime in. You may also want to post this question on our Facebook page. The depletion of B cells is the goal of Rituxan treatment, but obviously not complete destruction. A little research (by no means exhaustive) didn't find any studies looking at the complete depletion of B cells. Many studies look at the bounce back of B cells or the amount/quantity of B cells in bone marrow at various points following treatment. This study for the Arthritis Research & Therapy Journal concluded "This reduction of CD27+ B cells does not prevent autoantibody production suggesting that mechanisms regulating the formation of auto reactive clones are not disrupted by rituximab:" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2745807/. Have your doctors said anything about the frequency of conditions like yours? So glad that the IgG infusions are so helpful and thank you for bringing this issue to the community. It certainly would be helpful for the RA community if frequency of this problem was cataloged. Best, Richard (RheumatoidArthritis.net Team)
