Skip to main content
SpringerLink
Log in

Repeated administrations of rituximab along with steroids and immunosuppressive agents in refractory steroid-resistant nephrotic syndrome

  • Case Report
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

Abstract

Background

A recent randomized control trial in children with steroid-resistant nephrotic syndrome revealed that two doses of rituximab did not reduce proteinuria.

Case characteristics

A 14-month-old boy developed refractory steroid-resistant nephrotic syndrome due to focal segmental glomerulosclerosis.

Observation

The patient achieved complete remission 11 months after disease onset following eight doses of rituximab combined with steroids and cyclosporine.

Message

Long-lasting B cell depletion with repeated rituximab administrations may be required to achieve complete remission in patients with steroid-resistant nephrotic syndrome and massive proteinuria.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bagga A, Sinha A, Moudgil A. Rituximab in patients with the steroid-resistant nephrotic syndrome. N Engl J Med. 2007;356:2751–2.

    Article  CAS  PubMed  Google Scholar 

  2. Kari JA, El-Morshedy SM, El-Desoky S, Alshaya HO, Rahim KA, Edrees BM. Rituximab for refractory cases of childhood nephrotic syndrome. Pediatr Nephrol. 2011;26:733–7.

    Article  PubMed  Google Scholar 

  3. Magnasco A, Ravani P, Edefonti A, Murer L, Ghio L, Belingheri M, et al. Rituximab in children with resistant idiopathic nephrotic syndrome. J Am Soc Nephrol. 2012;23:1117–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Fernandez-Fresnedo G, Segarra A, González E, Alexandru S, Delgado R, Ramos N, et al. Rituximab treatment of adult patients with steroid-resistant focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2009;4:1317–23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Kamei K, Ito S, Nozu K, Fujinaga S, Nakayama M, Sako M, et al. Single dose of rituximab for refractory steroiddependent nephrotic syndrome in children. Pediatr Nephrol. 2009;24:1321–8.

    Article  PubMed  Google Scholar 

  6. Fujinaga S, Hirano D, Nishizaki N, Kamei K, Ito S, Ohtomo Y, et al. Single infusion of rituximab for persistent steroiddependent minimal-change nephrotic syndrome after longterm cyclosporine. Pediatr Nephrol. 2010;25:539–4.

    Article  PubMed  Google Scholar 

  7. Counsilman CE, Jol-van der Zijde CM, Stevens J, Cransberg K, Bredius RG, Sukhai RN. Pharmacokinetics of rituximab in a pediatric patient with therapy-resistant nephrotic syndrome. Pediatr Nephrol. 2015;30:1367–70.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Fujinaga S, Ozawa K, Sakuraya K, Yamada A, Shimizu T. Late-onset adverse events after a single dose of rituximab in children with complicated steroid-dependent nephrotic syndrome. Clin Nephrol. 2016;85:340–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Saitama Children’s Medical Center, 2100 Magome, Iwatsuki-ku, Saitama-city, Saitama, 339 8551, Japan

    Shuichiro Fujinaga

  2. Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan

    Koji Sakuraya

Authors
  1. Shuichiro Fujinaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koji Sakuraya
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shuichiro Fujinaga.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fujinaga, S., Sakuraya, K. Repeated administrations of rituximab along with steroids and immunosuppressive agents in refractory steroid-resistant nephrotic syndrome. Indian Pediatr 54, 49–50 (2017). https://doi.org/10.1007/s13312-017-0996-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-017-0996-3

Keywords

Search

Navigation