AJSP2203 - CME/CMLE - Histologic Findings and Tissue B-Cell Depletion in Endoscopic Mucosal Biopsy Specimens of the Gastrointestinal Tract After Treatment With Rituxima-Histologic Findings and Tissue B-Cell Depletion in Endoscopic Mucosal Biopsy Specimens of the Gastrointestinal Tract After Treatment With Rituxima

Histologic Findings and Tissue B-Cell Depletion in Endoscopic Mucosal Biopsy Specimens of the Gastrointestinal Tract After Treatment With Rituxima

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The study investigated histologic findings of tissue B-cell depletion in gastrointestinal (GI) biopsies following treatment with rituximab (RTX). Despite earlier evidence suggesting RTX-induced inflammatory pathology in the GI tract, the study found that tissue B-cell depletion may not be the primary cause of such inflammation. However, a subset of patients showed potential RTX-induced effects, notably presenting with a lymphocytic colitis pattern of injury (LCPI). Examining 93 patients who underwent endoscopic biopsies post-RTX treatment, the study revealed that B cells were depleted in a third of patients with inflammatory pathology. Further analysis showed similar rates of tissue B-cell depletion in patients with and without inflammatory pathology, suggesting other mechanisms may be involved. Notably, two patients demonstrated a strong association between RTX exposure and the development of LCPI. These cases highlighted a possible causal relationship between tissue B-cell depletion induced by RTX and gastrointestinal pathology. Additional factors, such as concurrent medications or comorbidities, were also considered. The study emphasizes the complexity of identifying direct RTX-induced GI adverse events and the need for further research in understanding these effects. The study's retrospective nature and limited sample size were acknowledged as study limitations, highlighting the need for larger, controlled studies to confirm these findings.

Keywords

histologic findings

tissue B-cell depletion

gastrointestinal biopsies

rituximab treatment

inflammatory pathology

lymphocytic colitis pattern of injury

endoscopic biopsies

RTX exposure

gastrointestinal pathology

adverse events