Rituximab 1 case report of adverse reactions and nursing.doc

 PAGE \* MERGEFORMAT 5 Rituximab 1 case report of adverse reactions and nursing [Keywords:] Rituximab, adverse reactions, nursing Rituximab, also known as rituximab injection, is a chimeric monoclonal antibody that specifically combine with the membrane antigen CD 20 .95% of the B cell non-Hodgkin lymphoma cells express CD 20. rituximab and B cells of the CD 20 antigen, start-mediated B cell lysis in the immune response. rituximab in combination with chemotherapy can not only improve the induction of treatment efficacy, reduce relapse, has become the first-line treatment of aggressive lymphoma, the new standard [1]. A case report Patients, male, 27 years old, appeared in April 2008 left knee pain, left inguinal lymph nodes, with low heat. Left knee MRI Tip: left distal femur, tibia, fibula abnormal signal, the left popliteal soft tissue signal intensity. Ultrasonic Tip: kidneys multiple occupancy, double neck multiple lymph nodes, blood supply. lymph node biopsy Tip: malignant lymphoma (B cell type. immunohistochemistry showed: CD 20 +, CD 45 RA +, CD 3 - , CD 45 RO + a few cells, diagnosed as diffuse large B cell lymphoma. Bone marrow biopsy showed: hyperplasia with mild retardation, with scattered B cell infiltration. immunohistochemistry showed: CD 3 San +, CD 20 kitchen +, CD 79 kitchen +, CD 138 -, MPO + + +, Network staining showed: hyperplasia of reticular fibers. chest CT examination revealed: the limitations of interstitial lesions and right middle lobe with pleural thickening, adhesions, multiple mediastinal lymph nodes, right a small amount of pleural effusion. Because the patient CD 20 +, given CHOP (C cyclophosphamide, H doxorubicin, O vincristine, P prednisone) + rituximab treatment. patients at the 1st time 90 min infusion, there skin rash, rapid expansion of the body to the abdomen is obvious, rash largest 2 cm 2 cm, no leakage, joint pain complaints to the knee was immediately given dexamethasone 10 mg bolus, 1 g bolus of calcium g