The impact of Rituximab therapy on the chromosomes of patients with Rheumatoid arthritis.

The open prospective combined cytogenetic and clinical study investigated the impact of biological therapy Rituximab on number and structure of chromosomes in Rheumatoid arthritis patients. The purpose of this study was to investigate safety of Rituximab on chromosomes as well as cytotoxic therapy Methotrexate. A total of 8 seropositive Rheumatoid arthritis patients were analyzed for primary end point of eventual cytotoxic effect of Rituximab. Assessment was done before and 1 month later, actually 2 weeks after the administration of full course of Rituximab in infusion. Patients suffering from active Rheumatoid arthritis were randomly assigned according to established protocol to receive infusion of Rituximab in a full dose of 2.0 grams divided in a two doses of 1.0 gram on days 1 and 15. The lymphocytes from peripheral blood were cultured according to Moorhead method. The results obtained from this investigation showed that normal male and female karyogram was found after the full therapy of Rituximab. The results from this study, that was done on a rather small number of subjects, indicate that Rituximab does not express either clastogenic or aneugenic effects. But, co-finding of this study was that Methotrexate had a side effect on chromosomal aberration in one female RA patient, and after discontinuation of this treatment the normal karyogram was observed.

[Multicentric reticulohistiocytosis]. / Multicentrina retikulohistiocitoza.

A very rare inflammatory systemic rheumatic disorder--Multicentric reticulohistiocytosis--was described as a case report in this paper. A 22 year old female patient was presented with a destructive polyarthritis and prominent multiple skin nodules that pointed to possible presence of this rare disease. The final diagnosis was made based on the biopsy finding. Application of the cytotoxic drug Metotrexate in the therapy, besides non-steroidal anti-inflammatory drugs and corticosteroids, leaded to full remission with disappearance of skin changes.

[Pericarditis and exudative pleuritis in patients with systemic lupus erythematosus before and after therapy]. / Perikarditis i eksudativni pleuritis u bolesnika sa sistemskim eritemskim lupusom prije i poslije terapije.

AIM OF THE STUDY: To establish the presence of pericarditis and exudative pleuritis in patients with systemic lupus erythematosus (SLE) prior to and after glicocorticoid and cytotoxic therapy. PATIENTS AND METHODS: In 43 patients, 39 women and 4 men, with SLE (disease was diagnosed according to revised American College of Rheumatology ACR criterias, 1997), aged between 20 and 61 and averaged disease duration of 5.54 +/- 5.74 years, heart/lung radiology and heart echosonography were performed in order to discover possible serositis (pericarditis and exudative pleuritis) prior to and after cytotoxic and glucocorticoid therapy. RESULTS: The presence of pericarditis and exudative pleuritis was established in 20 patients (47%) before the therapy. After the therapy pericarditis was present in 2 patients, average volume of 150 ml, and exudative pleuritis was also present in phrenicocostal sinus, but its volume was minimal. This table is showing the results of our study on patients with SLE and serositis. The results were compared with the results of European and Belgrade group in year 2000. [table: see text] CONCLUSION: Higher frequency of serositis (pericarditis and exudative pleuritis) in our study is probably a result of more active disease, and the effects of cytotoxic and glucocorticoid therapy were satisfing exept in two patients who were resistant on therapy. That is the reason why we had to consider plasmapheresis.