Mixed Cryoglobulinaemia Vasculitis Treated with Obinutuzumab in a Patient Allergic to Rituximab
  • Margarida Gaudencio
    Department of Internal Medicine, Hospital Distrital da Figueira da Foz, EPE, Figueira da Foz, Portugal
  • Catarina Parente
    Department of Internal Medicine, Hospital Barreiro-Montijo, Lisboa, Portugal
  • Ana Catarina Lameiras
    Department of Internal Medicine, Hospital Fernando Fonseca, Lisboa, Portugal
  • António Marinho
    Department of Clinical Immunology, Centro Hospitalar do Porto, Porto, Portugal; Faculty of Medicine, Instituto de Ciências Biomédicas Abel Salazar, Porto, Portugal


Mixed cryoglobulinaemia, overlap syndrome, autoimmune diseases., remission, internal carotid vasculitis, obinutuzumab


Cryoglobulinaemia is defined as the presence of cryoglobulins in the serum, which are immunoglobulins that reversibly precipitate and form a gel when the temperature is <37ºC. Autoimmune diseases such as Sjogren’s syndrome, systemic lupus erythematosus and rheumatoid arthritis could be associated with mixed cryoglobulinaemia vasculitis (MCV). The treatment of MCV generally consists of glucocorticoids, cytotoxic agents such as cyclophosphamide, plasmapheresis or anti-CD20 monoclonal antibodies including rituximab. Here, we present a case of a 60-year-old woman who developed type II MCV in the context of overlap autoimmune disease and who has been treated with a new anti-CD20 agent, obinutuzumab.



  • Roccatello D, Saadoun D, Ramos-Casals M, Tzioufas AG, Fervenza FC, Cacoub P, et al. Cryoglobulinaemia. Nat Rev Dis Primers 2018;4(1):11.
  • Crickx E, Weill JC, Reynaud CA, Mahevas M. Anti-CD20-mediated B-cell depletion in autoimmune diseases: successes, failures and future perspectives. Kidney Int 2020;97:885–893.
  • Robak T, Robak E. New anti-CD20 monoclonal antibodies for the treatment of B-cell lymphoid malignancies. BioDrugs 2011;25:13–25.
  • Tobinai K, Klein C, Oya N, Fingerle-Rowson G. A review of obinutuzumab (GA101), a novel type II anti-CD20 monoclonal antibody, for the treatment of patients with B-cell malignancies. Adv Ther 2017;34:324–356.
  • Barnas J, Looney R, Anolik J. B cell targeted therapies in autoimmune disease. Curr Opin Immunol 2019;61:92–99.
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    Published: 2021-11-22
    Issue: 2021: Vol 8 No 11 (view)

    How to cite:
    Gaudencio M, Parente C, Lameiras AC, Marinho A. Mixed Cryoglobulinaemia Vasculitis Treated with Obinutuzumab in a Patient Allergic to Rituximab. EJCRIM 2021;8 doi:10.12890/2021_003019.

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