Interaction between tacrolimus and clindamycin

autoimmune thrombocytopenic purpura, autoimmune haemolytic anaemia, systemic lupus erythematosus and rheumatoid arthritis. [2–4] The production of antibody depends on the antigenically driven clonal expansion of B cells into antibody-producing effector plasma cells. Plasma cells are short-lived cells, and survival of the populations depends on differentiation from their progenitor B cells [5]. B-cell ablation with rituximab could prevent further plasma cell and subsequent antibody formation, extinguishing the inflammatory anti-GBM response. In our case, the anti-GBM titre did not decrease below reference level even though 51 L of plasma volume had been exchanged, suggesting a high rate of antibody formation. The rapid decline of antibody titre and proteinuria could very well have been due to a late effect of simultaneous earlier therapy, but the theory behind the use of rituximab does not rule out that the rituximab might have had beneficial effect on antibody formation.