B cells depletion as a value alternative therapeutic in pediatric autoimmune disorders: 3 case reports

Case 1 17-year-old boy referred to the Autoimmune Diseases Centre with symmetrical proximal muscle weakness, weight loss, dysphagia, periungual lesions and erythema of hands and eyelids with a year of evolution. Laboratory tests showed elevated lactate dehydrogenase, creatine kinase, transaminases and aldolase. Immunological/serological tests were negative. Capillaroscopy was compatible with Juvenile Dermatomyositis. Electromyography and muscle biopsy revealed nonspecific inflammatory myopathy. Corticosteroids were used but there was progression of disease. Rituximab was introduced with significant clinical improvement.