How do you approach management of a patient with persistent EBV infection and MAS despite treatment with Rituximab, anakinra and canakinumab?

Topics: Rheumatology • Rituximab • General Rheumatology • Macrophage activation syndrome • Autoinflammatory disorders

Would you consider alternative B cell depleting therapies such as ofatumumab or ocrelizumab?

Answer from: at Community Practice

The (presumed) rationale for B cell depletion in EBV-associated MAS is to deplete infected B cells that are potential targets for cytotoxic T/NK cells that may have perforin pathway defects leading to excessive/prolonged cytokine release. Failure of the MAS to resolve with steroids/anakinra/rituxima...

Comments

at Hudson Hospital & Clinic
Thank you. Very helpful. May start with cyclospori...

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