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Girişgen İ, Yüksel S, Pekal Y. Rituximab experience in children with nephrotic syndrome: what have we observed differently. Turk Pediatri Ars. 2020;55(1):60-66doi: 10.14744/TurkPediatriArs.2019.76148.
Girişgen, �. �., Yüksel, S., & Pekal, Y. (2020). Rituximab experience in children with nephrotic syndrome: what have we observed differently. Turk pediatri arsivi, 55(1), 60-66. https://doi.org/10.14744/TurkPediatriArs.2019.76148
Girişgen, İlknur, et al. "Rituximab experience in children with nephrotic syndrome: what have we observed differently." Turk pediatri arsivi vol. 55,1 (2020): 60-66. doi: https://doi.org/10.14744/TurkPediatriArs.2019.76148
Girişgen İ, Yüksel S, Pekal Y. Rituximab experience in children with nephrotic syndrome: what have we observed differently. Turk Pediatri Ars. 2020 Mar 09;55(1):60-66. doi: 10.14744/TurkPediatriArs.2019.76148. eCollection 2020. PMID: 32231451; PMCID: PMC7096562.
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Turk Pediatri Ars. 2020 Mar 09;55(1):60-66. doi: 10.14744/TurkPediatriArs.2019.76148. eCollection 2020.

Rituximab experience in children with nephrotic syndrome: what have we observed differently.

Turk pediatri arsivi

İlknur Girişgen, Selçuk Yüksel, Yücel Pekal

Affiliations

  1. Division of Pediatric Nephrology, Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, Turkey.
  2. Department of Pediatrics, Pamukkale University Faculty of Medicine, Denizli, Turkey.

PMID: 32231451 PMCID: PMC7096562 DOI: 10.14744/TurkPediatriArs.2019.76148

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 syndrome) 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/m

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.

Copyright: © 2020 Turkish Archives of Pediatrics.

Keywords: Children; nephrotic syndrome; rituximab

References

  1. Pediatr Nephrol. 2008 Aug;23(8):1269-79 - PubMed
  2. Clin Exp Nephrol. 2018 Feb;22(1):110-116 - PubMed
  3. Arch Dis Child. 1982 Jul;57(7):544-8 - PubMed
  4. Pediatr Nephrol. 2019 Jan;34(1):87-96 - PubMed
  5. Pediatr Nephrol. 2009 Aug;24(8):1433-8 - PubMed
  6. Clin J Am Soc Nephrol. 2016 Aug 8;11(8):1360-8 - PubMed
  7. Front Pediatr. 2019 May 10;7:178 - PubMed
  8. Pediatr Nephrol. 2004 Jul;19(7):794-7 - PubMed
  9. Pediatr Nephrol. 2015 Aug;30(8):1367-70 - PubMed
  10. Expert Opin Drug Saf. 2005 May;4(3):599-608 - PubMed
  11. Clin J Am Soc Nephrol. 2010 Dec;5(12):2207-12 - PubMed
  12. J Autoimmun. 2008 Feb-Mar;30(1-2):90-8 - PubMed
  13. Case Rep Nephrol. 2017;2017:1372859 - PubMed
  14. Pediatr Nephrol. 2008 Mar;23(3):481-5 - PubMed
  15. Pediatr Nephrol. 2011 May;26(5):733-7 - PubMed
  16. Haematologica. 2002 Feb;87(2):189-95 - PubMed
  17. Clin Exp Nephrol. 2017 Apr;21(2):193-202 - PubMed
  18. J Am Soc Nephrol. 2016 Jun;27(6):1811-22 - PubMed
  19. Nat Clin Pract Nephrol. 2006 Apr;2(4):221-30 - PubMed
  20. Paediatr Drugs. 2008;10(1):9-22 - PubMed
  21. Nephrol Dial Transplant. 2015 Jan;30(1):96-106 - PubMed
  22. Clin J Am Soc Nephrol. 2011 Jun;6(6):1308-15 - PubMed
  23. Pediatr Nephrol. 2010 Mar;25(3):461-8 - PubMed
  24. Clin J Am Soc Nephrol. 2007 Sep;2(5):932-7 - PubMed
  25. Nephrol Dial Transplant. 2012 Mar;27(3):1083-9 - PubMed
  26. Biomed Res Int. 2016;2016:3053706 - PubMed

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