1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2014-28-8-7 10.15844/pedneurbriefs-28-8-7 Autoimmune Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Rituximab in Autoimmune CNS Disease http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * http://orcid.org/0000-0002-0798-0131 Millichap John J. MD 1 2 Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 08 2014 31 10 2015 28 8 62 62 Copyright: © 2014 The Author(s) 2014 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Utility and safety of rituximab in pediatric autoimmune and inflammatory CNS disease

Investigators at University of Sydney, Australia, and 14 international centers assessed the utility and safety of rituximab in 144 children (median age 8 years, range 0.7-17; 103 female) with autoimmune and inflammatory disorders of the CNS.

 Opsoclonus Rankin Scale Rituximab

Investigators at University of Sydney, Australia, and 14 international centers assessed the utility and safety of rituximab in 144 children (median age 8 years, range 0.7-17; 103 female) with autoimmune and inflammatory disorders of the CNS. These included NMDAR encephalitis in 39 patients, opsoclonus myoclonus ataxia syndrome in 32, neuromyelitis optica spectrum disorder in 20, lupus erythematosus in 18, and other neuroinflammatory disorders in 35. A standardized questionnaire and Rankin Scale were used for a retrospective evaluation of treatment outcome. Infusion adverse events occurred in 18/144 (12.5%), including anaphylaxis in 3, and infection in 11 (7.6%), 2 of whom died. Benefit was reported in 125 (87%) patients, greater in patients treated early. The off-label use of rituximab should be restricted to disorders having significant morbidity and mortality. [1]

COMMENTARY. Suggested guidelines for rituximab treatment in children with neuroimmunologic conditions are listed in an editorial [2]. Originally approved by the FDA in 1997 for the treatment of B-cell non-Hodgkin lymphoma and later for rheumatoid arthritis, more recently it has been used in a variety of autoimmune disorders including multiple sclerosis.

Dale RC Brilot F Duffy LV Twilt M Waldman AT Narula S Utility and safety of rituximab in pediatric autoimmune and inflammatory CNS disease Neurology 2014 Jul 8 83 2 142 50 10.1212/WNL.0000000000000570 24920861 Chitnis T Waubant E B-cell depletion in children with neuroimmunologic conditions: the learning curve Neurology 2014 Jul 8 83 2 111 2 10.1212/WNL.0000000000000576 24920852