Acquired angioedema and rituximab-induced acute thrombocytopenia in splenic marginal zone lymphoma

Authors

  • Odd Terje Brustugun Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway https://orcid.org/0000-0002-5153-8391
  • Erik Waage Nielsen Department of Surgery, Nordland Hospital Trust, Bodø, Norway; Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway; Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway; Department of Pain Medicine and Research, Oslo University Hospital and University of Oslo, Norway https://orcid.org/0000-0002-8358-3226

DOI:

https://doi.org/10.2340/1651-226X.2025.43897

Keywords:

lymphoma, angioedema, rituximab, thrombocytopenia, rituximab-induced acute thrombocytopenia

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References

Swanson TJ, Patel BC. Acquired angioedema. Treasure Island, FL: StatPearls Publishing; 2025.

Caldwell JR, Ruddy S, Schur PH, Austen KF. Acquired inhibitor deficiency in lymphosarcoma. Clin Immunol Immunopathol. 1972;1:39–52.

https://doi.org/10.1016/0090-1229(72)90006-2 DOI: https://doi.org/10.1016/0090-1229(72)90006-2

Ziakas PD, Giannouli S, Psimenou E, Evangelia K, Tzioufas AG, Voulgarelis M. Acquired angioedema: a new target for rituximab? Haematologica. 2004;89:ELT13.

Castelli R, Wu MA, Arquati M, Zanichelli A, Suffritti C, Rossi D, et al. High prevalence of splenic marginal zone lymphoma among patients with acquired C1 inhibtor deficiency. Br J Haematol. 2016;172:902–8.

https://doi.org/10.1111/bjh.13908 DOI: https://doi.org/10.1111/bjh.13908

Fields T, Ghebrehiwet B, Kaplan AP. Kinin formation in hereditary angioedema plasma: evidence against kinin ­derivation from C2 and in support of ‘spontaneous’ formation of ­bradykinin. J AllergClin Immunol. 1983;72:54–60.

https://doi.org/10.1016/0091-6749(83)90052-0 DOI: https://doi.org/10.1016/0091-6749(83)90052-0

Melamed J, Alper CA, Cicardi M, Rosen FS. The metabolism of C1 inhibitor and C1q in patients with acquired C1-inhibitor deficiency. J Allergy Clin Immunol. 1986;77:322–6.

https://doi.org/10.1016/s0091-6749(86)80111-7 DOI: https://doi.org/10.1016/S0091-6749(86)80111-7

Geha RS, Quinti I, Austen KF, Cicardi M, Sheffer AL, Rosen FS. Acquired C1-inhibitor deficiency associated with antiidiotypic antibody to monoclonal immunoglobulins. N Engl J Med. 1985;312:534–40.

https://doi.org/10.1056/NEJM198502283120902 DOI: https://doi.org/10.1056/NEJM198502283120902

Jackson J, Sim RB, Whelan A, Feighery C. An IgG autoantibody which inactivates C1-inhibitor. Nature. 1986;323:722–4.

https://doi.org/10.1038/323722a0 DOI: https://doi.org/10.1038/323722a0

Cicardi M, Zanichelli A. Acquired angioedema. Allergy Asthma Clin Immunol. 2010;6:14.

https://doi.org/10.1186/1710-1492-6-14 DOI: https://doi.org/10.1186/1710-1492-6-14

Lahuna C, Defendi F, Bouillet L, Boccon-Gibod I, Mekinian A, Coppo P, et al. Angioedema due to acquired C1-inhibitor deficiency associated with monoclonal gammopathies of undetermined significance characteristics of a French National Cohort. J Allergy Clin Immunol Pract. 2024;12:3283–91.

https://doi.org/10.1016/j.jaip.2024.09.016 DOI: https://doi.org/10.1016/j.jaip.2024.09.016

Stammler R, Defendi F, Aubineau M, Bibes B, Boccon-Gibod I, Bouillet L, et al. Angioedema due to acquired C1-inhibitor deficiency without hematological condition: a multicenter French cohort study of 34 patients. J Allergy Clin Immunol Pract. 2025;13:542–50.e2.

https://doi.org/10.1016/j.jaip.2024.12.027 DOI: https://doi.org/10.1016/j.jaip.2024.12.027

Tekin ZE, Yener GO, Yüksel S. Acquired angioedema in ­juvenile ­systemic lupus erythematosus: case-based review. Rheumatol Int. 2018;38:1577–84.

https://doi.org/10.1007/s00296-018-4088-z DOI: https://doi.org/10.1007/s00296-018-4088-z

Walport MJ. Complement and systemic lupus erythematosus. Arthritis Res. 2002;4 Suppl 3:S279–93.

https://doi.org/10.1186/ar586 DOI: https://doi.org/10.1186/ar586

Calatroni M, Moroni G, Conte E, Stella M, Reggiani F, Ponticelli C. Anti-C1q antibodies: a biomarker for diagnosis and ­management of lupus nephritis. A narrative review. Front Immunol. 2024;15:1410032.

https://doi.org/10.3389/fimmu.2024.1410032 DOI: https://doi.org/10.3389/fimmu.2024.1410032

Kleiner GI, Giclas P, Stadtmauer G, Cunningham-Rundles C. Unmasking of acquired autoimmune C1-inhibitor deficiency by an angiotensin-converting enzyme inhibitor. Ann Allergy Asthma Immunol. 2001;86:461–4.

https://doi.org/10.1016/S1081-1206(10)62496-9 DOI: https://doi.org/10.1016/S1081-1206(10)62496-9

Mann H, Pandey S, Pokhriyal S, Kusayev J, Dufresne A. Losartan-induced angioedema: a case report. Cureus. 2023;15:e37818.

https://doi.org/10.7759/cureus.37818 DOI: https://doi.org/10.7759/cureus.37818

Rigamonti C, Volta C, Colombi S, Forti L, Savinelli F, Gaidano G, et al. Severe thrombocytopenia and clinical bleeding associated with rituximab infusion in a lymphoma patient with massive splenomegaly without leukemic invasion. Leukemia. 2001;15:186–7.

https://doi.org/10.1038/sj.leu.2401987 DOI: https://doi.org/10.1038/sj.leu.2401987

Kars TU, Yorgancı ZF, Yaşkıran O, Tekinalp A, Demircioğlu S. Rituximab-induced severe acute thrombocytopenia in a patient with splenic marginal zone lymphoma. J Oncol Pharm Pract. 2023;29:1011–4.

https://doi.org/10.1177/10781552221142870 DOI: https://doi.org/10.1177/10781552221142870

Published

2025-07-09

How to Cite

Brustugun, O. T., & Nielsen, E. W. (2025). Acquired angioedema and rituximab-induced acute thrombocytopenia in splenic marginal zone lymphoma. Acta Oncologica, 64, 868–871. https://doi.org/10.2340/1651-226X.2025.43897