I got a 1000 milligrams rituximab a week ago and am scheduled to get the second 1000 next week. I also increased my prednisone meds to 60 mg a day but am also continuing on my AZA maintenance meds during my treatment.

The last two nights I have experience areas on my legs that become very red and inflamed with extreme itching. Scratching doesn't help. They look as if they have been burned. Regular lotion for dry skin doesn't help much. Some cream for itching helps a little. The other treatment that seems to help some is to put very hot packs on the inflamed area being careful not to burn oneself. The first time it was on the right leg and the second time on the left leg and the inflammation went all the way down to the foot. By morning the inflammation seems to have dissipated and the skin does not look any different.

I have experienced periodic skin sores in the past as part of the residual symptoms for GPA along with the others that are more frequent than typical like mouth sores, inflammation of the eyelids, fatigue, joint pain, etc. and the treatment so far seems to have relieved most of the inflammation and pain but I have also developed thrush.


The other problem I'm having is the increased belching from my long-standing Gerd which is probably due to the increase prednisone meds. The acid irritates my esophagus and in the past I have been admitted to the hospital thinking I was developing stenosis of the esophagus. In each case it turned out to be irritation and inflammation caused by the acid from the GERD.I also take the maximum dose each of generic Mucinex to avoid the irritation of my throat from the post nasal drip that results from the sinus damage.


Since I haven't had to deal with treating a flare for many years I'm uncertain if any of the symptoms are being caused by the rituximab? Or if there are any coping mechanisms that others have found effective in managing such symptoms that I could try.

I also have type I diabetes for several decades and the increase prednisone is making managing my blood glucose levels very challenging and I frequently have problems either going too high or too low. Usually my Dexcom CGM and do-it-yourself looping system on my iPhone are able to keep me informed enough for me to keep tweaking my insulin levels to keep me safe enough to remain on an outpatient basis though I've had some close calls.