Please use this identifier to cite or link to this item: 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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