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+====== Rituximab ======
+[[Rituximab]] (trade names Rituxan, MabThera and Zytux) is a chimeric [[monoclonal antibody]] against the protein [[CD20]], which is primarily found on the surface of immune system [[B cell]]s. [[Rituximab]] destroys [[B cell]]s and is therefore used to treat diseases which are characterized by excessive numbers of B cells, overactive B cells, or dysfunctional B cells. This includes many [[lymphoma]]s, [[leukemia]]s, transplant rejection, and autoimmune disorders.
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+[[Rituximab]] is available since [[1997]] for the treatment of refractory systemic [[B-cell]] [[non-Hodgkin lymphoma]]. [[Intrathecal]]ly may be more effective for [[CD33]] + lymphomas.
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+There is no specific treatment protocol for IgG4 related pachymeningitis.
+The first-line therapy is steroids and second-line is chemotherapy [[(methotrexate]], [[azathioprine]], etc.). We describe a patient with IgG4-related pachymeningitis in whom steroid use was contraindicated and methotrexate was ineffective. During the course of treatment, the patient presented to the emergency department with receptive and expressive aphasia, slurred speech, right-sided neglect, and loss of sensation. After a single infusion of [[rituximab]] and anticonvulsants, her symptoms resolved. Our unique case suggests that patients with IgG4-related pachymeningitis might benefit from early initiation of rituximab
+((Gospodarev V, Câmara J, Chakravarthy V, Perry A, Wood M, Dietz R, Wang J, De Los Reyes K, Raghavan R. Treatment of IgG4-related pachymeningitis in a patient with steroid intolerance: The role of early use of rituximab. J Neuroimmunol. 2016 Oct 15;299:62-65. doi: 10.1016/j.jneuroim.2016.08.009. Epub 2016 Aug 16. PMID: 27725123.))