Schnitzler syndrome: treatment failure to rituximab but response to anakinra

J Am Acad Dermatol. 2007 Aug;57(2):361-4. doi: 10.1016/j.jaad.2007.03.036. Epub 2007 Apr 30.

Abstract

Schnitzler syndrome is a rare disease characterized by a chronic urticarial rash and a monoclonal gammopathy. The exact pathogenesis is still uncertain and treatment remains a challenge. Here, we report a patient who was only recently given the diagnosis of Schnitzler syndrome although the typical symptoms had been present for about 6 years. Administration of the B-cell antibody rituximab did not exert any beneficial effect despite effective elimination of B cells and a reduction of the paraprotein. In contrast, injection of the interleukin-1-receptor antagonist anakinra caused a complete remission within a few days.

Publication types

  • Case Reports

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Drug Therapy, Combination
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunologic Factors / therapeutic use*
  • Injections, Subcutaneous
  • Interleukin 1 Receptor Antagonist Protein / administration & dosage
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use*
  • Male
  • Middle Aged
  • Prednisolone / therapeutic use
  • Receptors, Interleukin-1 / antagonists & inhibitors*
  • Retreatment
  • Rituximab
  • Schnitzler Syndrome / drug therapy*
  • Schnitzler Syndrome / pathology
  • Time Factors
  • Treatment Failure
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Glucocorticoids
  • Immunologic Factors
  • Interleukin 1 Receptor Antagonist Protein
  • Receptors, Interleukin-1
  • Rituximab
  • Prednisolone