Efficacy of Rituximab in Managing Refractory Juvenile Systemic Lupus Erythematosus with Macrophage Activation Syndrome: A Case Report and Literature Review

This case report discusses the successful use of Rituximab in managing a refractory case of juvenile systemic lupus erythematosus (jSLE) complicated by macrophage activation syndrome (MAS) in a 16-year-old female. The patient, who had a history of SLE with frequent flares, initially received intravenous methylprednisolone and antibiotics for MAS and bacterial sepsis. Due to the disease's refractoriness to conventional treatment, Rituximab was administered, allowing for the tapering and eventual cessation of oral prednisolone without further flares. One year post-treatment, the patient remained symptom-free. The report highlights Rituximab as a promising adjunct therapy for jSLE, potentially reducing the adverse effects of long-term glucocorticoid use in pediatric patients. However, further randomized controlled trials are needed to establish its long-term efficacy and safety in children.