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Rituximab-induced serum sickness in a girl with nephrotic syndrome

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Abstract

Rituximab (RTX) has been used to treat B cell lineage lymphoma/leukemia or autoimmune or autoinflammatory disorders. RTX therapy has been extensively applied to cases of frequently relapsing nephrotic syndrome (FRNS) and steroid-dependent nephrotic syndrome. Rituximab-induced serum sickness (RISS) has been recognized as a rare severe type-3 hypersensitivity reaction in patients treated with RTX. We herein report a 10-year-old girl with RISS in FRNS. She was diagnosed with RISS based on characteristic symptoms, such as a fever, rash, arthritis, or proteinuria, during RTX therapy associated with a high level of human anti-chimeric antibody. Even after recovering from acute symptoms by RISS, she suffered from worsening relapses of nephrotic syndrome. The symptoms of RISS are non-specific, resembling viral infections, autoinflammatory diseases and Kawasaki disease, especially in children. While RISS is a rare complication among patients with nephrotic syndrome, it should be carefully considered as a severe complication in patients being treated with RTX.

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Authors and Affiliations

  1. Department of Pediatrics, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5593, Japan

    Yuka Kimura, Kyoko Kiyota, Mayo Ikeuchi, Kazuhito Sekiguchi & Kenji Ihara

Authors
  1. Yuka Kimura
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  2. Kyoko Kiyota
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  3. Mayo Ikeuchi
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  4. Kazuhito Sekiguchi
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  5. Kenji Ihara
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Correspondence to Kazuhito Sekiguchi.

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Informed consent was obtained from the parents of the patient included in this case report.

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Kimura, Y., Kiyota, K., Ikeuchi, M. et al. Rituximab-induced serum sickness in a girl with nephrotic syndrome. CEN Case Rep 11, 506–510 (2022). https://doi.org/10.1007/s13730-022-00709-y

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