Year: 2026
Type: article
Study design: Case Report
Abstract: Rituximab (RTX) is a chimeric monoclonal antibody against CD20-expressing B lymphocytes, widely used in B-cell malignancies. Although generally well-tolerated, pulmonary toxicity is a rare but potentially fatal complication. A 71-year-old male with hepatic non-Hodgkin lymphoma (NHL) in remission, on maintenance RTX, presented with a one-month history of fever, asthenia, and progressive dyspnea. Initial management for suspected community-acquired pneumonia with levofloxacin failed. Despite temporary improvement on piperacillin/tazobactam, symptoms recurred after discharge, progressing to hypoxemic respiratory failure. Extensive workup, including bronchoalveolar lavage (BAL) and positron emission tomography-computed tomography (PET-CT), ruled out infection and lymphoma relapse. Following a multidisciplinary review, RTX-induced organizing pneumonia (OP) was suspected. Initiation of high-dose methylprednisolone (250 mg/day) led to rapid clinical and radiological resolution. RTX-induced OP requires a high index of suspicion, as its clinical-radiological presentation mimics infectious pneumonia. Early recognition and prompt initiation of corticosteroids are associated with rapid clinical and radiological recovery and may reduce the risk of progression to irreversible pulmonary fibrosis.
Source: Cureus
Institution: Unidade Local de Saúde de Coimbra
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7220360115