Combination Immunosuppressive Therapy Including Rituximab for Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis in Adult-Onset Still’s Disease

<div>Clinical response in relation to treatment with rituximab, anakinra, and cyclosporine. (a) Fever curve and treatment overview. Body temperature was taken twice a day via an infrared ear thermometer. Rituximab was started on day 6 at a dose of 375 mg/m<sup>2</sup> and repeated once a week indicated by an arrow until virus suppression was achieved after the third infusion. Anakinra was started on day 8 at a dose of 100 mg daily and cyclosporine on day 19 at a dose of 200 mg daily (blood level aiming at 100 <i>μ</i>g/L). (b) Correlating laboratory parameters over time. Dotted lines indicate the respective upper reference ranges. CRP: C-reactive protein; EBV: Epstein-Barr virus; GGT: gamma-glutamyltransferase.</div>

Case Reports in Rheumatology

fig1

Figure 1

Figure 1: Combination Immunosuppressive Therapy Including Rituximab for Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis in Adult-Onset Still’s Disease 

Figure 1 | Combination Immunosuppressive Therapy Including Rituximab for Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis in Adult-Onset Still’s Disease 