Rituximab therapy for steroid-dependent minimal change nephrotic syndrome.
We present a patient with steroid-sensitive but high-dose steroid-dependent nephrotic syndrome who was treated with rituximab. For 9 months following therapy she had undetectable CD19 cells in the peripheral circulation. She remained in remission during this period even though therapy was reduced to low-dose, alternate day prednisolone only. After 9 months, CD19 cells were once again detectable. Shortly after CD19 cells became detectable again she relapsed. We conclude that B-lymphocytes play a central role in the pathogenesis of idiopathic minimal change nephrotic syndrome (MCNS) and that rituximab may have a useful role in the management of steroid-dependent patients.
Gilbert
Rodney D
RD
Regional Paediatric Nephro-Urology Unit, Child Health Department Southampton General Hospital, Tremona Road, Southampton, S16 6YD, UK. rodney.gilbert@suht.swest.nhs.uk
Hulse
Eleanor
E
Rigden
Susan
S
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D007223:Infant; D009402:Nephrosis, Lipoid / Q000188:drug therapy*; D009404:Nephrotic Syndrome / Q000188:drug therapy*; D011241:Prednisone / Q000627:therapeutic use*; D000069283:Rituximab; D013256:Steroids / Q000737:chemistry*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D013256:Steroids; D000069283:Rituximab; D011241:Prednisone