Rituximab-induced hypogammaglobulinemia in autoimmune cytopenia and associated diseases.
Abstract
INTRODUCTION: Rituximab is used for treating autoimmune cytopenia and associated diseases including autoimmune haemolytic anaemia; immune thrombopenia, systemic lupus erythematosus and antiphospholipid syndrome. However, rituximab may induce acquired immune deficiency in some patients, particularly hypogammaglobulinemia (HG), whose risk factors remain poorly defined. PATIENTS AND METHODS: We conducted a retrospective multicentre study including patients with autoimmune cytopenia and related diseases who received at least one rituximab infusion to validate serum protein electrophoresis (SE) as a screening tool for HG and to assess its incidence, risk factors, and clinical outcomes. Univariate and multivariate Cox analysis were performed to characterize predictor of HG. RESULTS: ). HG, defined as gammaglobulin levels <7g/L on SE after rituximab exposure, occurred in 14.9% of patients and was associated with a higher cumulative number of rituximab injections (median 11 vs. 1.5; P=0.033). All immunoglobulin isotypes declined after treatment, and severe infections were more frequent in HG patients. Although cumulative rituximab dose and corticosteroid exposure were associated with HG in univariate analysis, these findings were not confirmed in multivariate models. CONCLUSION: SE appears to be a reliable screening tool for HG, but larger studies are needed to clarify risk factors.
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BibTeX
@article{sormani2026rituximabinduced,
title = {{Rituximab-induced hypogammaglobulinemia in autoimmune cytopenia and associated diseases.}},
author = {Jonathan Sormani and Alexandre Belot and David Goncalves and Magali Dechomet and Pascal Seve and Arnaud Hot and Laetitia Koppe and Sandrine Lemoine and Cyrille Confavreux and Hervé Ghesquieres and Sarah Benezech and Isabelle Durieu and Quitterie Reynaud},
journal = {La Revue de Médecine Interne},
year = {2026},
month = sep,
doi = {10.1016/j.revmed.2026.07.015},
url = {https://hal.science/hal-05750624v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Rituximab-induced hypogammaglobulinemia in autoimmune cytopenia and associated diseases.
AU - Jonathan Sormani
AU - Alexandre Belot
AU - David Goncalves
AU - Magali Dechomet
AU - Pascal Seve
AU - Arnaud Hot
AU - Laetitia Koppe
AU - Sandrine Lemoine
AU - Cyrille Confavreux
AU - Hervé Ghesquieres
AU - Sarah Benezech
AU - Isabelle Durieu
AU - Quitterie Reynaud
PY - 2026
DA - 2026/09/15
JO - La Revue de Médecine Interne
DO - 10.1016/j.revmed.2026.07.015
UR - https://hal.science/hal-05750624v1
AB - INTRODUCTION: Rituximab is used for treating autoimmune cytopenia and associated diseases including autoimmune haemolytic anaemia; immune thrombopenia, systemic lupus erythematosus and antiphospholipid syndrome. However, rituximab may induce acquired immune deficiency in some patients, particularly hypogammaglobulinemia (HG), whose risk factors remain poorly defined. PATIENTS AND METHODS: We conducted a retrospective multicentre study including patients with autoimmune cytopenia and related diseases who received at least one rituximab infusion to validate serum protein electrophoresis (SE) as a screening tool for HG and to assess its incidence, risk factors, and clinical outcomes. Univariate and multivariate Cox analysis were performed to characterize predictor of HG. RESULTS: ). HG, defined as gammaglobulin levels <7g/L on SE after rituximab exposure, occurred in 14.9% of patients and was associated with a higher cumulative number of rituximab injections (median 11 vs. 1.5; P=0.033). All immunoglobulin isotypes declined after treatment, and severe infections were more frequent in HG patients. Although cumulative rituximab dose and corticosteroid exposure were associated with HG in univariate analysis, these findings were not confirmed in multivariate models. CONCLUSION: SE appears to be a reliable screening tool for HG, but larger studies are needed to clarify risk factors.
SN - 0248-8663
SN - 1768-3122
ER -