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Research letter
Novel use of rituximab in hypersensitivity pneumonitis refractory to conventional treatment
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  1. Harpreet K Lota1,
  2. Gregory J Keir1,
  3. David M Hansell2,
  4. Andrew G Nicholson3,
  5. Toby M Maher1,
  6. Athol U Wells1,
  7. Elisabetta A Renzoni1
  1. 1Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
  2. 2Department of Radiology, Royal Brompton Hospital, London, UK
  3. 3Department of Histopathology, Royal Brompton Hospital, London, UK
  1. Correspondence to Dr Harpreet K Lota, Interstitial Lung Disease Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK; h.lota{at}rbht.nhs.uk

https://doi.org/10.1136/thoraxjnl-2013-203265

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    Hypersensitivity pneumonitis (HP) is treated by removal of the inciting antigen, if identified, and with corticosteroids and immunosuppressive agents in extensive or progressive disease. A minority of patients continue to decline and suffer outcomes comparable to idiopathic pulmonary fibrosis. Rituximab, a B cell depleting anti-CD20 antibody, has shown benefit in interstitial lung diseases (ILDs) associated with connective tissue diseases (CTDs).1–3 We report a novel use of rituximab in a case of HP refractory to conventional treatment.

    A 57-year-old female never-smoker, with no previous medical history, presented with a 6-month history of progressive breathlessness and dry cough. Pulmonary function tests (PFTs) were impaired, with 26% of diffusing capacity for carbon monoxide (DLco) and 44% of forced vital capacity (FVC). A high-resolution CT (HRCT) showed changes suggestive …

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