Delayed Rituxan Reaction, Maybe?

[brettgrant99]

I had my first Rituxan infusion last Friday. No real problems with the infusion. Felt pretty well afterwards, just tired. Yesterday I was out running errands and suddenly turned very cold with muscle and joint pain. Called my RA, he had me come in. I had a high heart rate and minor fever. He was mostly concerned that this was an infection from all of the prednisone. He didn't think it was the Rituxan and infection quite yet.

I was just wondering if it could be a delayed reaction to the infusion? If this happened the day of or day after, I think everyone would say that it was just a post-infusion reaction. However, I am not sure if I can expect such a reaction four days later. Dr sent me to ER for blood and chest x-ray. They were mostly concerned that I had the flu. AFAK, he didn't even look up the side effects of Rituxan. I was pretty disappointed in the care there. They couldn't even take my BP correctly. It kept coming up low for me (90/50) and they just said no problem, its ok. Ah. My doctor staffed my case with someone there, but somehow I got shunted to someone else. Argh. They basically sent me home with a clean bill of health, no meds. Chest x-ray was good, though.

The more I think about it, I think this is just standard side effects of Rituxan, I was just surprised that they occurred 4 days later. My next infusion is on Friday, I am waiting to hear if we proceed.

[pberggren1]

I would be betting on the RTX.

[Debbie C]

I didn't know you get an infection from too much pred but what do I know:predrage:

[brettgrant99]

Turns out I have pneumonia. Just addmitted to the hospital.

oh well

[windchime]

Oh Brett, I guess you are on forced bed rest now. Out of curiosity how did they diagnose pneumonia if the chest X-ray was clear? Feel better and keep us posted. Hugs to to you. :hug2:

[Alysia]

Hi, I just wrote to you on fb too.
I know someone who got kind of "pneomonia" which was a complication of rtx. please check it with your docs. maybe the links can help:
Pneumocystis pneumonia in patients treated with rituxi... [Chest. 2013] - PubMed - NCBI (http://www.ncbi.nlm.nih.gov/pubmed/23258406)
Pneumocystis jiroveci pneumonia following rituximab treatment in Wegener's granulomatosis - Hugle - 2010 - Arthritis Care & Research - Wiley Online Library (http://onlinelibrary.wiley.com/doi/10.1002/acr.20279/pdf)
Rituximab-induced lung disease: a systematic literature review (http://erj.ersjournals.com/content/35/3/681.full)

I hope you will soon feel better. I am sending you lots of hugs and prayers. please update us.

[marta]

I was reading this thread and signed in before reading to the end and was going to say that you could have gotten something that sets in quick and is especially likely after RTX treatment because you now have obliterated your B-cells (although you've only done one so you should in theory still have at least half of them circulating). The combination of the steroids and the RTX makes you more vulnerable to viral, fungal and bacterial infections. It takes about 6-8 months for your bone marrow to produce a new batch of B's, but I'm guessing you're not going to go through the next set of infussion(s).

Take care in there and stay away from sick people. I know it's easy to say and hard to do in a hospital, but that will be your saving grace in this particular immune suppressed predicament. There's nasty flu stuff going around and you can't tax the system too much more right now. Eat well, rest and close your door to too many visitors.

All the best.

[brettgrant99]

Out of the hospital and now at home. Finally a good night's sleep! :)