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Rituximab therapy for steroid-dependent minimal change nephrotic syndrome
Rodney D Gilbert1, Eleanor Hulse, Susan Rigden
1Regional Paediatric Nephro-Urology Unit, Child Health Department Southampton General Hospital, Tremona Road, Southampton, S16 6YD, UK. rodney.gilbert@suht.swest.nhs.uk
Abstract:
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.
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