Key result
Rituximab therapy is linked to severe enteroviral meningoencephalitis complicated by cortical blindness.
Why the study?
Patients with hypogammaglobulinemia are predisposed to chronic enteroviral meningoencephalitis, which had not been previously reported in a patient treated with rituximab for psoriatic arthritis.
Case Report (n=1)
No
Clinicians should consider chronic enteroviral meningoencephalitis in immunocompromised patients receiving prolonged rituximab therapy for rheumatologic conditions such as psoriatic arthritis who present with encephalopathy.
Answers are grounded in this paper and cite their sources.
Supports considering chronic enteroviral meningoencephalitis in rituximab-treated psoriatic arthritis patients with encephalopathy; extends malignancy reports but remains hypothesis-generating.
family. Enteroviruses derive their name from the way they are typically transmitted via the intestinal tract. They commonly infect millions of people every year and often do not cause severe disease in immunocompetent patients with few exceptions. Aseptic meningitis is a classic manifestation and is usually self-limited, however, can lead to severe neurological complications in an immunocompromised individual. It has been well-described that patients with hypogammaglobulinemia are predisposed to developing chronic enteroviral meningoencephalitis [1]. This is the first reported case of enteroviral meningoencephalitis in a patient being treated for psoriatic arthritis with rituximab. Here we describe a 46-year-old female who presented with altered mental status, fever, and myalgia. Polymerase chain reaction (PCR) of her cerebrospinal fluid (CSF) confirmed the presence of enterovirus. In the immunocompromised patient with encephalopathy, it is important to consider an enteroviral infection. This case adds to the present body of knowledge about enteroviral infections in immunocompromised hosts.
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Tellez et al. (2019) conducted a case report in Chronic enteroviral meningoencephalitis associated with rituximab therapy for psoriatic arthritis (n=1). Rituximab was evaluated on Clinical course and neurological outcome following chronic enteroviral meningoencephalitis treated with IVIG. Rituximab therapy for psoriatic arthritis was associated with chronic enteroviral meningoencephalitis in a 46-year-old female, resulting in cortical blindness and encephalomalacia at 10 months.
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