Fig. 1.

– Summary of laboratory studies and radiography: Trends in CRP, CD20⁺ B-cells, anti-IFNγ antibody levels, and changes in magnetic resonance imaging (MRI) of the pelvis pre- and post-bortezomib. C-reactive protein (solid red line) and CD20⁺ B-cells (solid blue line) changes over time and their relationship to rituximab (blue bars) and bortezomib (red bar) initiation. The vertical, red-dotted line represents time of clinical disease relapse (top-left). Anti-IFNγ autoantibody titers were highest on initial diagnosis as depicted by an increased fluorescence intensity throughout multiple Log10 dilutions (squares – top right). These titers decreased with rituximab but overall remained elevated pre-bortezomib (triangles). They decreased further after bortezomib was added to the rituximab regimen (circles). See supplementary materials for detailed methodology. Representative image of MRI pelvis post-contrast demonstrates significant soft tissue inflammation throughout the left obturator internus and pelvic sidewall (arrowheads) and the left biceps femoris (arrows) prior to bortezomib despite multiple antimycobacterial antibiotics and rituximab (bottom-left). Repeat MRI pelvis with contrast after one year of bortezomib shows resolution of soft tissue inflammation in these areas (bottom-right).