Severe enterovirus infections in patients with immune-mediated inflammatory diseases receiving anti-CD20 monoclonal antibodies
Authors' conclusion
Anti-CD20 mAbs may lead to impaired B-cell response against EV, although an underlying primary immunodeficiency should systematically be discussed.
Study context
- Population
- Patients with immune-mediated inflammatory diseases (IMIDs) receiving anti-CD20 monoclonal antibodies (mAbs) with severe enterovirus (EV) infections9 original, 17 published cases
- Participants
- 26 patients
- Outcome
- Clinical features of severe EV infections in IMID patients receiving anti-CD20 mAbs (case series and literature review)
Methodological detailsnational surveillance data
- National surveillance data
Main finding
As reported in the abstract
- Meningoencephalitis (most common manifestation)
- n=21/26, 81%
- EV-positive cerebrospinal fluid
- n=20/22, 91%
- Mortality rate
- 27%
- EV the only causal agent
- all reported cases
- Anti-CD20 mAb infusions, median (range)
- 8 (5-10)
- Hypogammaglobulinemia (moderate), median IgG level
- 4.9 g/L (4.3-6.7)
Observational data: associations, not effects.
Further findings
Neutralising antibodies in a patient with chronic EV-A71 meningoencephalitis
- Lack of B-cell response to EV
Original publication
Severe enterovirus infections in patients with immune-mediated inflammatory diseases receiving anti-CD20 monoclonal antibodies. RMD Open. Published 20 May 2024. doi:10.
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