title: Successful use of rituximab in the treatment of childhood and juvenile pemphigus.
abstract: BACKGROUND
  There is a lack of data on outcomes of management of pemphigus in children.
  
  
  OBJECTIVE
  We sought to evaluate rituximab treatment in childhood and juvenile pemphigus.
  
  
  METHODS
  All cases of pemphigus treated with rituximab in patients younger than 18 years were included. Clinical and epidemiologic data and details of rituximab administration were recorded. Response to treatment was assessed as control of disease activity, partial remission, complete remission, and relapse/flare.
  
  
  RESULTS
  Ten patients aged 9 to 17 years received rituximab treatment. After therapy, they were followed up for a median period of 16 months (range 8-36 months). Complete remission without concomitant therapy was achieved in 7 patients by a mean of 21 weeks. One patient each achieved complete remission (on immunosuppressant therapy), control of disease activity, and partial remission (on immunosuppressant therapy) by 15, 8, and 14 weeks, respectively. Relapse/flare occurred in 6 patients by a mean period of 13 months. Two patients received a second cycle of rituximab infusions with good clinical response. Infusion reactions were the most common adverse event. There were no long-term complications.
  
  
  CONCLUSIONS
  Small sample size and retrospective study design are limitations.
  
  
  CONCLUSIONS
  The current data suggest that rituximab is useful in treating childhood and juvenile pemphigus.
authors.affiliation: Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Keshavamurthy
authors.initials: K
authors.lastname: Vinay
authors.affiliation: Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address: ajkanwar1948@gmail.com.
authors.forename: Amrinder J
authors.initials: AJ
authors.lastname: Kanwar
authors.affiliation: Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Gitesh U
authors.initials: GU
authors.lastname: Sawatkar
authors.affiliation: Department of Dermatology, Venereology, and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
authors.affiliation: Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
mesh_terms: D000293:Adolescent; D000367:Age Factors; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010392:Pemphigus / Q000175:diagnosis* / Q000188:drug therapy*; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D000069283:Rituximab; D012494:Sampling Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab
keywords: autoimmune bullous diseases; childhood pemphigus vulgaris; juvenile pemphigus vulgaris; rituximab