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https://hdl.handle.net/11499/37277
Title: | Rituximab experience in children with nephrotic syndrome: What have we observed differently | Authors: | Girişgen, İlknur Yüksel, Selçuk Pekal, Yücel |
Keywords: | Children Nephrotic syndrome Rituximab adalimumab albumin CD19 antigen CD20 antigen chlorpheniramine corticosteroid creatinine cyclophosphamide cyclosporine methylprednisolone paracetamol prednisone rituximab tacrolimus adolescent Article child childhood disease clinical article controlled study creatinine blood level drug efficacy face redness female focal glomerulosclerosis follow up human humoral immune deficiency immunosuppressive treatment kidney biopsy kidney function male nephrotic syndrome preschool child protein urine level proteinuria pruritus remission retrospective study school child skin disease steroid therapy throat itching treatment duration |
Publisher: | Kare Publishing | Abstract: | Aim: We aimed to evaluate the efficacy of rituximab therapy in children with nephrotic syndromes and to share our experiences. Material and Methods: Twelve children with nephrotic syndrome (four with steroid-dependent, eight with steroid-resistant nephrotic syn-drome) who were treated with rituximab were retrospectively evaluated in terms of clinical and laboratory data and CD19-20 levels. All patients received rituximab (375 mg/m2) once weekly for 4 weeks. A proteinuria-free period under steroid therapy was not sought prior to initiating rituximab therapy. Results: The overall remission rates in patients with steroid-dependent and steroid-resistant nephrotic syndrome were 100% and 27%. Focal segmental glomerulosclerosis was diagnosed in six patients and the remission rate was 33% in this population. CD19 cell depletion was observed in 10 of the 12 children. Seven of the 10 patients with CD19 depletion achieved remission, whereas the other three had persistent nephrotic proteinuria despite CD19 depletion. Two patients without CD19 depletion never achieved remission. Relapse occurred in three of the seven patients associated with increased CD19. Conclusion: We observed that rituximab could be given without waiting for a proteinuria-free period under steroid therapy. Our result suggest that administering four weekly doses of rituximab increases the likelihood of remission, considering the amount of drug lost in the urine of children with nephrotic proteinuria. However, our findings must be confirmed with dose-comparison studies conducted with larger populations and an evaluation of long-term adverse effects. Some patients did not achieve remission despite B cell depletion, which suggests that B cell depletion is necessary but insufficient for remission in nephrotic syndromes. © 2020 by Turkish Pediatric Association. | URI: | https://hdl.handle.net/11499/37277 https://doi.org/10.14744/TurkPediatriArs.2019.76148 |
ISSN: | 1306-0015 |
Appears in Collections: | PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection Tıp Fakültesi Koleksiyonu TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection |
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