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Chronic neuropathy with IgM anti-ganglioside antibodies: Lack of long term response to rituximab

From the Department of Neurology, Neuromuscular Unit (Drs. Rojas-García, and Illa), Laboratory of Experimental Neurology (Drs. Gallardo, de Andrés, de Luna), and the Department of Immunology (Dr. Juarez), Hospital de la Sta Creu i St Pau and Institut de Recerca HSCSP, Universitat Autònoma de Barcelona; and Department of Neurology (Dr. Sánchez), Clínica Puerta de Hierro, Madrid, Spain.

Address correspondence and reprint requests to Dr. Isabel Illa, Department of Neurology, Hospital de Sant Pau, Padre Claret 167, 08025 Barcelona, Spain; e-mail: iilla{at}hsp.santpau.es

Two patients with chronic motor neuropathy, high antiganglioside antibody (AGA) titers, and a declining response to IV immunoglobulins were treated with rituximab at a standard dose. The drug was well tolerated and effectively eliminated peripheral B cells (CD20+), but AGA titers continued significantly high. No clinical improvement was detected during the 1-year follow-up.

Received February 25, 2003. Accepted in final form August 20, 2003.

Presented at the 54th annual meeting of the American Academy of Neurology; Denver, CO; 2002.

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