Which of the following is a common adverse reaction during a rituximab infusion?

• A. Mucositis
• B. Angioedema
• C. Rigors
• D. Renal toxicity

Answer: (C)

Infusion-related reactions are a common issue with rituximab, driven by cytokine release as B cells are targeted. The most typical event during the infusion is rigors—sudden, intense shivering often accompanied by fever. This tends to happen with the first infusion and may include flushing or mild shortness of breath. Management focuses on slowing the infusion rate and using premedication such as acetaminophen and an antihistamine, sometimes with steroids, to reduce the reaction.

Mucositis is more a side effect of many cytotoxic chemotherapies that damage mucosal linings, not a classic rituximab infusion reaction. Angioedema can occur with infusion reactions but isn’t the most characteristic sign of rituximab in the infusion setting. Renal toxicity isn’t a common direct adverse effect of rituximab infusions.