{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:18:19Z","timestamp":1787894299018,"version":"build-2784847793"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012165","name":"Key Technologies Research and Development Program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012165","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We investigated the incidence of infections and hypogammaglobulinemia (HGG) in patients with myasthenia gravis (MG) receiving long-term low-dose rituximab (RTX) maintenance therapy and identified related risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study enrolled MG patients treated with low-dose RTX maintenance. Cox proportional hazards regression was performed to analyze risk factors for infections and HGG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 186 patients were included. The median age at RTX initiation was 52.50 years, and the median follow-up was 2.41 years. Infections occurred in 29 patients (15.59%), with a median time to first infection of 170.37 days, mostly during the first cycle. The 1- and 2-year infection rates were 13.41 (95% confidence interval [CI], 8.47\u201320.28) and 9.20 (95% CI, 6.06\u201313.36) per 100 person-years. Severe infections developed in 21 patients (11.29%). The most prevalent infection was lower respiratory tract infection (LRTI), with 19 episodes (61.29%). HGG was present in 51 patients (27.42%). HGG was an independent risk factor for infection (HR\u00a0=\u00a05.53, P&amp;lt;0.001). Higher baseline prednisone dose (HR\u00a0=\u00a01.25, P\u00a0=\u00a00.035) and HGG (HR\u00a0=\u00a07.50, P&amp;lt;0.001) were significantly correlated with increased risk of severe LRTIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In MG patients receiving long-term low-dose RTX maintenance, the overall infection incidence is relatively low, with LRTIs being the most frequent. HGG is a major independent risk factor for infections and severe LRTIs, while higher baseline prednisone doses were associated with severe LRTIs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1907574","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:30:41Z","timestamp":1787891441000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Infections and hypogammaglobulinemia in myasthenia gravis patients receiving low-dose rituximab: a real-world cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Rongjing","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Ruan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sijia","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonglan","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangqi","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuyi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi\u2019an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tangdu Hospital, The Fourth 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