{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:23:38Z","timestamp":1762917818481,"version":"3.40.4"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,9,12]]},"abstract":"<jats:p>Corticosteroids are the first-line treatment for patients with inflammatory myopathies. Myositis can be a clinical feature of scleroderma (polymyositis\u2013scleroderma overlap syndrome), and treatment of this syndrome is a challenge for clinicians because moderate to high doses of corticosteroids are considered a risk factor for development of acute kidney injury in affected patients. We report here the case of a 56-year-old woman with scleroderma who developed polymyositis and was successfully treated with rituximab. Initial treatment of the polymyositis with prednisolone 40\u2009mg\/day was rapidly tapered to 2.5\u2009mg\/day due to development of scleroderma renal crisis, for which four weekly infusions of rituximab (500\u2009mg; off-label) were given. She responded well to rituximab in addition to prednisolone 2.5\u2009mg\/day. Rituximab may improve inflammatory myopathies, even in cases where high-dose corticosteroids should be avoided due to complications. Rituximab should be considered as a treatment option in cases of refractory polymyositis.<\/jats:p>","DOI":"10.1136\/bcr-2017-221205","type":"journal-article","created":{"date-parts":[[2017,9,23]],"date-time":"2017-09-23T09:05:23Z","timestamp":1506157523000},"page":"bcr-2017-221205","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Successful treatment using rituximab in a patient with refractory polymyositis complicated by scleroderma renal crisis"],"prefix":"10.1136","volume":"2017","author":[{"given":"Kyoko","family":"Innami","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Mukai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoko","family":"Kodama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshitaka","family":"Morita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,9,23]]},"reference":[{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.10.017"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.2","first-page":"14","article-title":"Scleroderma overlap syndrome","volume":"13","author":"Balbir-Gurman","year":"2011","journal-title":"Isr Med Assoc J"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.3","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199809)41:9<1613::AID-ART11>3.0.CO;2-O"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.4","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awv332"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909905"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909169"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1404231"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.8","doi-asserted-by":"publisher","DOI":"10.1002\/art.30427"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.37754"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2014.12.001"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.11","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000182028","article-title":"Clinical course of patients with scleroderma renal crisis treated with captopril","volume":"27","author":"Zawada","year":"1981","journal-title":"Nephron"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.09.008"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.13","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1780320911"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.14","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1000-x"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.15","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.111592"},{"key":"2025042712403603000_2017.sep21_1.bcr-2017-221205.16","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1016\/S0140-6736(89)92416-1","article-title":"Cyclophosphamide in severe polymyositis","volume":"1","author":"Bombardieri","year":"1989","journal-title":"Lancet"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T19:40:43Z","timestamp":1745782843000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,9,23]]},"references-count":16,"alternative-id":["10.1136\/bcr-2017-221205"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221205","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2017,9,23]]}}}