title: Treatment of recurrent focal segmental glomerulosclerosis in pediatric kidney transplant recipients: effect of rituximab.
abstract: Recurrence of focal segmental glomerulosclerosis (FSGS) after renal transplantation is a complication that often leads to graft loss. There is no consensus on the optimal treatment of recurrent FSGS. Rituximab, a monoclonal antibody to CD20, may be a useful treatment of this complication. Methods. We report four pediatric cases of recurrent FSGS treated with rituximab and plasmapheresis. Results. Four children (2M/2F), age 15.3 ± 2.6, with recurrent FSGS posttransplant were identified. Four doses of rituximab were administered 171 ± 180 days posttransplant and 114 ± 169 days after the start of plasmapheresis. Three children responded with complete remission, one of whom relapsed after four months. One child had a partial response with a decrease in proteinuria that was not sustained. No adverse side effects were reported during treatment or followup (mean 22.5 months). Conclusions. Rituximab is a safe and well-tolerated ancillary treatment for recurrent FSGS in pediatric patients in conjunction with plasmapheresis.
authors.affiliation: Division of Nephrology, Department of Pediatrics, Cohen Children's Medical Center of New York, 269-01 76th Avenue, New Hyde Park, NY 11040, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Sethna
authors.forename: Corinne
authors.initials: C
authors.lastname: Benchimol
authors.forename: Hilary
authors.initials: H
authors.lastname: Hotchkiss
authors.forename: Rachel
authors.initials: R
authors.lastname: Frank
authors.forename: Lulette
authors.initials: L
authors.lastname: Infante
authors.forename: Suzanne
authors.initials: S
authors.lastname: Vento
authors.forename: Howard
authors.initials: H
authors.lastname: Trachtman