Eur J Endocrinol
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DOI: 10.1530/eje.1.02140
European Journal of Endocrinology, Vol 154, Issue 5, 623-632
Copyright © 2006 by European Society of Endocrinology
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REVIEW

The rationale for B lymphocyte depletion in Graves’ disease. Monoclonal anti-CD20 antibody therapy as a novel treatment option

Daniel El Fassi1,3, Claus H Nielsen3, Hans C Hasselbalch2 and Laszlo Hegedüs1

1 Departments of Endocrinology and Metabolism and 2 Hematology, Odense University Hospital, 5000, Odense C, Denmark and 3 Institute for Inflammation Research, Rigshospitalet National University Hospital, Copenhagen, Denmark

(Correspondence should be addressed to D El Fassi; Email: fassi{at}dadlnet.dk)

Abstract

We have reviewed the immunology of thyroid autoimmunity with special reference to the importance of B lymphocytes (B cells) in thyroidal and extrathyroidal Graves’ disease (GD), thus providing a framework for the hypothesis that B cell depletion may be beneficial in GD. Additionally, after reviewing the efficacy and safety in other autoimmune diseases, we propose that treatment with the B cell-depleting agent Rituximab may become a clinically relevant treatment option in selected cases of GD, particularly when complicated with thyroid-associated ophthalmopathy.




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