Other anti-CD20 monoclonals
The efficacy and success of rituximab has led to some other anti-CD20 monoclonal antibodies being developed:

ocrelizumab, humanized (90%-95% human) B cell-depleting agent. ofatumumab (HuMax-CD20) a fully human B cell-depleting agent. Third-generation anti-CD20s such as obinutuzumab have a glycoengineered Fc fragment (Fc) with enhanced binding to Fc gamma receptors, which increase ADCC (antibody-dependent cellular cytotoxicity). This strategy for enhancing a monoclonal antibodys ability to induce ADCC takes advantage of the fact that the displayed Fc glycan controls the antibodys affinity for Fc receptors. References
External links
"Rituximab". Drug Information Portal. U.S. National Library of Medicine. "Discovery – Development of Rituximab". National Cancer Institute. 7 March 2014.
Other signs of a basilar skull fracture include CSF otorrhoea (drainage of CSF through the ear). It can have devastating complications in some patients, as the communication between the nasal cavity, the cerebrospinal fluid and the central nervous system can result in severe bacterial infections.CSF rhinorrhoea may be a complication of neurosurgery, such as functional endoscopic sinus surgery, and hypophysectomy (partial or complete removal of the pituitary gland). Non-traumatic
CSF rhinorrhoea may be caused by the growth of certain cancers (such as pituitary adenoma), congenital problems with bones of the skull, or inflammation that damages the bones of the skull. Diagnosis
Radiology
If a patient has clear, colourless liquid leaking from the nose, then radiographs or CT scans may be used to look for a basilar skull fracture. Biochemistry
Measures of CSF components, such as glucose, have been used in the past, but are neither sensitive nor specific. Beta-2 transferrin has a high positive predictive value of CSF rhinorrhoea. It has also been noted to be characterized by unilateral discharge. Treatment
Surgery
Neurosurgery is usually necessary to prevent the spread of infection to the meninges. Minimally invasive techniques tend to have fewer complications compared to open techniques. Conservative management
Conservative management includes watchful waiting, as some minor CSF leaks often stop spontaneously. See also
Beta-2 transferrin
Meningitis
Traumatic head injury

References


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