Central nervous system inflammatory demyelination after rituximab therapy for idiopathic thrombocytopenic purpura Academic Article uri icon


MeSH Major

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Central Nervous System Diseases
  • Demyelinating Diseases
  • Purpura, Thrombocytopenic, Idiopathic


  • A 53-year-old female developed unilateral shoulder girdle pain, entire body paresthesiae and imbalance starting 10 days after completing a course of rituximab for chronic idiopathic thrombocytopenic purpura. Neuroimaging studies showed inflammatory demyelinating lesions of the cervical spinal cord and cerebellum. Immunocytochemistry of spinal fluid lymphocytic pleocytosis showed an absolute B cell depletion and a polyclonal/inflammatory T cell response. Intravenous immunoglobulin infusions were associated with clinical and radiological improvements. Anti-CD20-therapy possibly resulted in an imbalance between B cell and T cell populations in the central nervous system, and may have triggered a predominantly cell-mediated immune attack against unidentified nervous system antigens.

publication date

  • January 15, 2010



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1016/j.jns.2009.10.009

PubMed ID

  • 19897212

Additional Document Info

start page

  • 178

end page

  • 81


  • 288


  • 1-2