SHM Converge Scientific Abstract ePoster Gallery-Rituximab Induced Interstitial Lung Disease in Patient With Non-Hodgkin Lymphoma

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This poster presents a case of rituximab-induced interstitial lung disease (DI-ILD) in a 76-year-old man with non-Hodgkin lymphoma. After treatment with rituximab, he developed shortness of breath and acute hypoxemic respiratory failure. CT imaging showed bilateral upper and lower lobe ground-glass opacities. Because of worsening respiratory status, he required intubation and bronchoscopy. An extensive workup was otherwise negative, and the clinical timeline supported a diagnosis of rituximab-induced ILD.<br /><br />The patient was treated with a prednisone taper, improved clinically, was successfully extubated, and discharged after 19 days. Follow-up CT imaging one month later showed only minimal pulmonary scarring, suggesting significant recovery.<br /><br />The discussion highlights that rituximab, a monoclonal antibody against CD20 on B-lymphocytes, can rarely cause immune-mediated DI-ILD, likely through a type IV hypersensitivity mechanism. Diagnosis is strengthened when symptoms improve after stopping the drug. Management typically includes prompt corticosteroid therapy, and re-challenge is generally avoided because of the risk of mortality. The poster notes an estimated mortality of 37.5% for rituximab-associated lung disease.<br /><br />The authors emphasize that hospitalists should suspect this complication in patients receiving rituximab who develop acute respiratory symptoms, especially around 15 days after the last infusion and after the fourth treatment cycle. Chest radiography is recommended as an initial and reliable diagnostic tool, and early steroid treatment may improve outcomes.

Asset Subtitle

Jessica Mary

Meta Tag

Author List Abigail Immanuel, Jasmine Varughese, Jessica Mary, Pooja Shekar

Category Clinical Vignettes

Concept Rituximab

Concept Drug-Induced Lung Injury

Concept Drug Discontinuation

Concept Hypoxemic Respiratory Failure

Concept Ground-Glass Opacities

Distinguished Non-Finalist

Presenter Organization University of Connecticut

Presenting Author Jessica Mary

Track Adult

Keywords

rituximab-induced interstitial lung disease

drug-induced interstitial lung disease

non-Hodgkin lymphoma

acute hypoxemic respiratory failure

ground-glass opacities

bronchoscopy

prednisone taper

corticosteroid therapy

CD20 monoclonal antibody

rituximab-associated lung disease

Rituximab

Drug-Induced Lung Injury

Drug Discontinuation

Hypoxemic Respiratory Failure

Ground-Glass Opacities