Rituximab is a biologic agent that is usually well tolerated. With its increasing use for a myriad of rheumatologic and immunologic conditions, post-marketing surveillance has revealed more side effects. Systemic inflammatory response syndrome associated with cytokine release syndrome (CRS) is a very rare entity associated with the use of rituximab and carries a very high morbidity and case fatality rate. Cases of CRS reported within the literature are of patients with a very high tumor burden leading to a catastrophic cascade of events. We report the case of a patient having post-transplant lymphoproliferative disorder who died of fatal lactic acidosis and CRS within 24 h of receiving rituximab. Understanding the pathophysiology of such cases and identifying patients at risk may help to possibly avert this life-threatening complication.

Original languageEnglish
Pages (from-to)134-140
Number of pages7
JournalCase Reports in Oncology
Issue number1
StatePublished - Jan 2012


  • Cytokine release syndrome
  • Fatality
  • Lactic acidosis
  • Mortality
  • Post-transplant lymphoproliferative disorder
  • Rituximab
  • Systemic inflammatory response syndrome


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