Key result
Rituximab-induced persistent B-cell depletion was associated with fatal acute liver failure due to echovirus 9 infection 3 years after therapy in a 19-year-old man.
Case Report (n=1)
No
Rituximab-induced B-cell depletion can persist for years and is a critical risk factor for severe enterovirus infections, including fatal acute liver failure.
May warrant prolonged infection vigilance after rituximab; leaves open optimal monitoring and prophylaxis strategies.
We describe a case of fatal acute liver failure due to echovirus 9 in the setting of persistent B-cell depletion and hypogammaglobulinemia 3 years after rituximab therapy. Metagenomic next-generation sequencing further specified the etiologic agent. Early recognition may provide an opportunity for interventions including intravenous immunoglobulin and liver transplantation.
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Bajema et al. (2017) conducted a case report in Acute liver failure due to echovirus 9 (n=1). Rituximab was evaluated on Clinical outcome (acute liver failure and death). Rituximab-induced persistent B-cell depletion was associated with fatal acute liver failure due to echovirus 9 infection 3 years after therapy in a 19-year-old man.
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