Batna Journal of Medical Sciences
Volume 10, Numéro 1, Pages 30-33
2026-02-02

Successful Use Of Rituximab In Severe, Non-viral Cryoglobulinemic Vasculitis Complicated By Recurrent Infections And Macrophage Activation Syndrome



Authors : Haddouche Assia . Nait Said Hiba . Ammar Boudjelal Safa . Arzour Belamine Hind . Hanni Fella .

Abstract

Non-viral mixed cryoglobulinemic vasculitis is a rare small-vessel vasculitis, frequently associated with autoimmune diseases. Its management is complex, particularly when severe manifestations require potent immunosuppression, which carries significant risks. We report the case of a 42-year-old male with longstanding seropositive rheumatoid arthritis and secondary Sjögren’s syndrome, who developed severe mixed cryoglobulinemic vasculitis complicated by recurrent skin infections and macrophage activation syndrome. Initial immunosuppressive therapy was interrupted due to successive bacterial infections. Plasmapheresis was then initiated but was rapidly complicated by macrophage activation syndrome. After stabilization with corticosteroids and intravenous immunoglobulin, rituximab was introduced as salvage therapy, leading to sustained clinical and biological remission. This case highlights the challenges of managing non-infectious cryoglobulinemic vasculitis in the context of connective tissue disease overlap, secondary infections, and life-threatening complications such as MAS. Rituximab demonstrated excellent efficacy and safety in this complex clinical setting.

Keywords

Cryoglobulinemia ; Macrophage Activation Syndrome ; Rheumatoid Arthritis ; Sjögren's Syndrome ; Rituximab.

Les articles similaires

Epidemiological, Diagnostic, And Therapeutic Aspects Of Community-acquired Complicated Intra-abdominal Infections At The University Hospital Center Of Constantine, Algeria.

Charaoui Khalida .  Boulakehal Nadia .  Bouchair Zoheir .  Belmir Ali .  Kaoueche Omar .  Benlabed Kaddour .  Kara-mostefa Rafik . 
pages 1-9.

Syndrome Digestif Chronique Révélant Un Déficit Immunitaire Commun Variable Compliqué D’un Syndrome D’activation Macrophagique : à Propos D’un Cas

Guettaf Imane .  Rechach Adel .  Charifi Meriem .  Fellah Nora .  Chibane Ahcene . 
pages 66-71.

Syndrome De Good Et Infections Respiratoires Multifocales.

Baough L. .  Mekideche D. .  Meliouen A. .  Bellal A.r. .  Nekhla A. .  Gaffor M. .  Moubrit M. .  Asselah F. .  Zidouni N. . 
pages 275-278.

Le Syndrome Respiratoire Aigu Sévère Et Ses Incidences Sur Les Droits De L'homme

Mahdjoub Azzedine . 
pages 73-78.

Cryoglobulinémie De Type I à Iga Lambda Se Manifestant Par Un Cryogel Massif Et Un Syndrome Hémorragique Sévère Révélant Un Myélome Multiple : à Propos D'un Cas

Ahmidatou Hadjira .  Assaous Hadjer .  Kellouche Soraya .  Khouni Nesma .  Kaci Zohra . 
pages 75-80.

Formats de citation