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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Thursday, July 29, 2010
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NetWellness provides the highest quality health information and education services created and evaluated by faculty of our partner universities.
Thursday, July 29, 2010
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Bleeding and Clotting Disorders |
Autoimmune Hemolytic Anemia02/19/2007 |
There was not a topic on autoimmune hemolytic anemia. My question is, after being treated with many different immunosuppressants and several rounds of steroids my doctors decided to try Rituxan, now I am told that my CD4 count is less than 200 and my CD4 % is 7; my absolute lymph was 172, what should I be doing to bring these counts up? I’m terrified that I might catch something and not be able to fight it off. Should I be staying out of public places? My doctors have told me nothing so far. Will the CD4 counts come back up on their own? I caught cryptoccocal meningitis in July 2005 and almost died because my immune system was suppressed. It’s taken two years for me to get back on my feet and it really scares me to think that I could catch something so serious again.
What you are describing in terms of the lymphopenia and the decreased CD4 count are likely a result of the treatment with rituximab, which is thought to be effective via the suppression of the cells that produce antibodies. That can lead to many autoimmune diseases, of which autoimmune hemolytic anemia is one. The suppression, though, is transient and should only last roughly 5-9 months.
You are correct in that you may be at increased risk of infection, but you don't need to do anything different. Rituximab-treated patients have really not had a dramatic increased risk of infection unless other concurrent immune suppressive medications are given at the same time. You should contact your doctor immediately, though, if you get a fever or feel badly in other ways.
I hope this helps out. For more specific answers, you really should discuss these issues with your physician.
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Spero R. Cataland, MD Clinical Asst. Professor of Internal Medicine James Cancer Hospital & Solove Research Institute Hematology and Oncology College of Medicine The Ohio State University |
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