[CIS PIDD] [cis-pidd] Nodular lymphoid hyperplasia and rituximab

[Maglione, Paul]

Charlotte has used rituximab to treat pulmonary hyperplasia in CVID, and nodular lymphoid hyperplasia falls into the category of PLH. We published that here:

J Allergy Clin Immunol.<http://www.ncbi.nlm.nih.gov/pubmed/24131823#> 2014 Feb;133(2):535-42. doi: 10.1016/j.jaci.2013.08.022. Epub 2013 Oct 13.
Tertiary lymphoid neogenesis is a component of pulmonary lymphoid hyperplasia in patients with common variable immunodeficiency.

I'd also argue that your patient has a form of GLILD - granulomas aren't always called by the pathologists, but I would say all forms of PLH fall into GLILD. Then of course you have the best evidence so far for the usage of rituximab which is the Medical College of Wisconsin study.

J Clin Immunol.<http://www.ncbi.nlm.nih.gov/pubmed/22930256#> 2013 Jan;33(1):30-9. doi: 10.1007/s10875-012-9755-3. Epub 2012 Aug 29.
Use of combination chemotherapy for treatment of granulomatous and lymphocytic interstitial lung disease (GLILD) in patients with common variable immunodeficiency (CVID).
Chase NM<http://www.ncbi.nlm.nih.gov/pubmed?term=Chase%20NM%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>1, Verbsky JW<http://www.ncbi.nlm.nih.gov/pubmed?term=Verbsky%20JW%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Hintermeyer MK<http://www.ncbi.nlm.nih.gov/pubmed?term=Hintermeyer%20MK%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Waukau JK<http://www.ncbi.nlm.nih.gov/pubmed?term=Waukau%20JK%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Tomita-Mitchell A<http://www.ncbi.nlm.nih.gov/pubmed?term=Tomita-Mitchell%20A%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Casper JT<http://www.ncbi.nlm.nih.gov/pubmed?term=Casper%20JT%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Singh S<http://www.ncbi.nlm.nih.gov/pubmed?term=Singh%20S%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Shahir KS<http://www.ncbi.nlm.nih.gov/pubmed?term=Shahir%20KS%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Tisol WB<http://www.ncbi.nlm.nih.gov/pubmed?term=Tisol%20WB%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Nugent ML<http://www.ncbi.nlm.nih.gov/pubmed?term=Nugent%20ML%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Rao RN<http://www.ncbi.nlm.nih.gov/pubmed?term=Rao%20RN%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Mackinnon AC<http://www.ncbi.nlm.nih.gov/pubmed?term=Mackinnon%20AC%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>,Goodman LR<http://www.ncbi.nlm.nih.gov/pubmed?term=Goodman%20LR%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Simpson PM<http://www.ncbi.nlm.nih.gov/pubmed?term=Simpson%20PM%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>, Routes JM<http://www.ncbi.nlm.nih.gov/pubmed?term=Routes%20JM%5BAuthor%5D&cauthor=true&cauthor_uid=22930256>.


PJ



PJ Maglione, MD, PhD
Clinical Fellow
Allergy/Immunology
Mount Sinai

________________________________
From: Sullivan, Kathleen [sullivak at mail.med.upenn.edu]
Sent: Friday, April 04, 2014 8:03 AM
To: CIS-PIDD
Subject: [cis-pidd] Nodular lymphoid hyperplasia and rituximab

Hi everyone!

I have an adult CVID patient with VERY severe NLH.  I treated him with rituximab but the insurance company is now refusing to pay.  Does anyone have ANY references for the use of rituximab in this condition?  I can't find any in PubMed and the insurance company will not re-review unless I can give them some data.

Thanks!

Kate
Sullivan, Kathleen, MD PhD
Professor of Pediatrics
Wallace Chair of Pediatrics
Division of Allergy Immunology
The Children's Hospital of Philadelphia
ARC 1216
3615 Civic Center Blvd
Philadelphia, PA 19104
sullivak at mail.med.upenn.edu<mailto:sullivak at mail.med.upenn.edu>






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