Rituximab is a valid alternative to standard of care in severe inflammatory neuropsychiatric lupus.

What is it about?

This is a case report on a young woman with lupus and severe inflammatory neuropsychiatric disturbances. We succesfully treated her by applying the principles of the two-hit treatment strategy recommended by EULAR using corticosteroids and Rituximab as induction therapies (first hit) and mycophenolate during maintenance (second hit), lowering inflammation, preventing accrue of damage, avoiding new relapse and reducing the use of corticosteroids.

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Why is it important?

B cells carry out central roles in the pathogenesis of SLE through a combination of antibody-mediated and antibodyindependent actions. Despite conflicting evidence from clinical trials, BCDT was proven to be effective in several lupus manifestations by inhibiting the interaction between functionally activated B cells and T cells and also possibly by reducing the production of certain cytokines and complement activation, which could lead to rapid improvement in NPSLE manifestations.

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