TABLE 1.
Cases reported with the use of anti-CD20 and IBD in MS patients.
| Reference | Age (sex) | Anti-CD20 | Time to first symptoms | Clinical features | Complementary tests | Histopathology | Treatment | Follow-up |
|---|---|---|---|---|---|---|---|---|
| Lee et al. (2020) | 43 (F) | OCR | 6 months | Diarrhoea and abdominal pain | CT: transverse and sigmoid colitis | Superficial mucosa ulceration, congestion, chronic inflammation and submucosal fibrosis | Hydrocortisone | Total colectomy due to lack of response |
| End.: nodular mucosa with white-yellow plaques | ||||||||
| Barnes et al. (2021) | 56 (F) | OCR | 18 months | Bloody diarrhoea and odynophagia | End.: deep ulcerations in oesophagus with inflammation from proximal until transverse colon | Colon: patchy chronic inflammation, moderately active with cryptitis and cryptica abscess without granulomas. No CD20+ detected in biopsy. | OCR discontinuation | 3 months: resolution of inflammation, biopsy with microscopic colitis |
| Oesophagus: mucosal ulceration with no viral inclusions or granulomas | Hydrocortisone iv followed by oral prednisone with tappering dose | 9 months: normal colonoscopy and biopsy | ||||||
| Au et al. (2022) | 45 (F) | OCR | 5 years | Diarrhoea and abdominal pain | End.: active ileitis | Mild patchy ileal inflammation | Vedolizumab and OCR | Recurrence at 5 months; azathioprine was added |
| Entero-MRI: active ileitis | ||||||||
| Shahmohammadi et al. (2018) | 31 (F) | RTX | Not available | Abdominal pain, fever, bloody diarrhoea | End.: rectal mucosa erythema, superficial ulcers and blood loss from sigmoid colon to cecum | Distrained colonic mucosa, irregularity of crypts, lymphoplasmacytic infiltrate in lamina propria without granulomas (UC) | RTX suspension | Complete clinical resolution |
| Hydrocortisone iv and 5-ASA | ||||||||
| Sunjaya et al. (2020) | 47 (M) | OCR | Several weeks (not specified) | Fever and bloody diarrhoea | CT: mural thickening in rectum | Non specifical severe chronical inflammation | Corticoids iv followed by oral prednisone lowering dose | Clinical recurrence at 4 weeks with similar lesions in endoscopy. Corticoids iv and hydrocortisone enemas were reiniciated without improvement. Finally, segmental sigmoidectomy |
| End.: haemorrhagic proctosigmoiditis with ulceration | ||||||||
| - | 38 (F) | RTX | 4 months after last cycle | Bloody diarrhoea, fever and perianal disease | End.: deep and superficial ulcers from ascendent colon to proximal sigma and deep ulcers, mucous bridges and a fistulous hole in anal mucosa at 2–3 cm from pectinate line | Colonic ulcers with granulation tissue. The features were compatible with Crohn disease | Intravenous corticosteroids followed by oral prednisone lowering dose and cefuroxime for the anal abscesses | Favourable evolution with initial treatment |
| Pelvic MRI: four abscesses adjacent to anal canal, two of them with intersphinteric fistulas and one of them in communication with the anal canal | Maintenance treatment was initiated due to perianal disease with ustekinumab | |||||||
| Malloy et al. (2022) | 40 (F) | OCR | not available | Postprandrial abdominal cramps | End.: mild patchy colitis | Histological evidence of severe rectal-sparing pancolonic inflammation | Initially mesalazine (discontinued due to intolerance) | Absence of clinical recovery despite treatment |
| Posterior End.: severe with rectal-sparing and pancolonic inflammation | Mercaptopurine | It was also refractory to metilprednisolone and ciclofosfamide, finally requiring subtotal colectomy |
5ASA: 5-aminosalicylic acid or mesalazine, CT: computerized tomography; End.: endoscopy; F: female; iv: intravenous; M: male; MRI: magnetic resonance imaging; OCR: ocrelizumab; RTX: rituximab; UC: ulcerative colitis.