B cells aren't just antibody factories, beta—they also help coordinate the whole immune team and have memory. Anti-CD20 treatment wipes them out, so antibody production drops, leaving you open to infections. I see this in my practice; a patient on rituximab for his arthritis now gets chest infections every monsoon. It reminds me of my sister in Bhopal, whose hostel room gets damp and mouldy—some defences, once gone, leave you vulnerable to the old, familiar troubles.
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