Acta clinica Croatica, Vol. 62. No. 2, 2023.
Book review
https://doi.org/10.20471/acc.2023.62.02.19
Refractory Guillain-Barré Syndrome in a Patient with Asymptomatic Multiple Myeloma Successfully Treated with Low-Dose Rituximab
Ivan Krečak
; Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia; Faculty of Medicine, University of Rijeka, Rijeka, Croatia
*
Velka Gverić-Krečak
; Department of Internal Medicine, General Hospital of Šibenik-Knin County, Šibenik, Croatia
* Corresponding author.
Abstract
Despite being extremely rare, Guillain-Barré syndrome (GBS) has been recognized
as a neurological complication of multiple myeloma, with variable responses to plasmapheresis (PEX),
intravenous immunoglobulins (IVIG), and anti-myeloma therapies. In this paper, we report a case of
a female patient with asymptomatic multiple myeloma (aMM) who initially presented as PEX- and
IVIG-refractory GBS. After failure of PEX, IVIG, and anti-myeloma therapy (bortezomib, melphalan,
and prednisone), the patient was eventually successfully treated with low-dose rituximab (100 mg/m2 per
week in four doses). To the best of our knowledge, this is the first case to report successful treatment of
refractory GBS potentially associated to aMM with low-dose rituximab. Additional studies are needed
to elucidate the pathophysiological processes and the interplay between the dysregulated immune response,
monoclonal immunoglobulin (MG), and neural tissue damage in GBS patients. Also, the potential
role of rituximab in the treatment of MG-associated GBS warrants further exploration.
Keywords
Guillain-Barré syndrome; Rituximab; Monoclonal immunoglobulin; Multiple myeloma
Hrčak ID:
308847
URI
Publication date:
1.8.2023.
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