Rituximab and bilateral HSV epithelial keratitis in a patient with mucous membrane pemphigoid

Journal of Ophthalmic Inflammation and Infection
Wolfgang BernauerL Borradori

Abstract

B cell depleting therapy is widely used for lymphoproliferative diseases and immune-mediated disorders, including mucous membrane pemphigoid. The latter is an autoimmune blistering disease affecting predominantly the mucosae potentially associated with devastating complications. A 71-year-old patient with severe mucous membrane pemphigoid involving ocular, oral pharyngeal and laryngeal involvement is described. To control the disease, the patient was given rituximab therapy in combination with oral corticosteroids. He subsequently experienced an epithelial herpes simplex virus keratitis in one eye and 3 months later in his fellow eye. Topical treatment with ganciclovir resulted in prompt recovery. For the first time, a correlation between rituximab and bilateral epithelial herpes simplex virus keratitis is described. Although rituximab is a promising biologic agent for the treatment of autoimmune diseases, it bears the risk of reactivation of viral infections, including the onset of herpes simplex virus keratitis.

References

Jun 1, 1981·The British Journal of Ophthalmology·K R WilhelmusB R Jones
Mar 8, 2003·Ophthalmology·Paula Márcia F SouzaAndrew J W Huang
Jul 7, 2007·Leukemia & Lymphoma·Sercan AksoyIbrahim Barista
Mar 23, 2011·Archives of Dermatology·Christelle Le Roux-VilletHervé Bachelez
Feb 21, 2013·Journal of Clinical Virology : the Official Publication of the Pan American Society for Clinical Virology·Jing Lu KrollUNKNOWN Type 1 Diabetes TrialNet Anti CD-20 Study Group
Mar 12, 2015·Ocular Immunology and Inflammation·Sarah SchulerWolfgang Bernauer

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Citations

Jul 18, 2019·Ophthalmology and Therapy·David B RosenPhillip C Hoopes
Oct 1, 2019·Current Opinion in Ophthalmology·Gabriel S Valerio, Charles C Lin

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Methods Mentioned

BETA
light microscopy

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