Rituximab Administration in Cortico-dependent and Frequently Relapsing Syndrome in Childhood

Abstract

Introduction: Childhood nephrotic syndrome most often presents as steroid- sensitive disease, but about 50-60% of patients have frequent relapses (FRNS) or show steroid-dependence (SDNS). For many years steroids (CS) have been the mainstay of treatment. Their sustained use exposes many children with FR/SDNS at increased risk for developing steroid toxicity. Alternative immunosuppressants are used to induce or maintain remission of nephrotic syndrome, for example rituximab (Rx). The drug is a monoclonal antibody against the CD20 receptor on B lymphocytes and has shown promising results in the treatment of childhood nephrotic syndrome.

Objective: The purpose of this review is to summarize the information currently available on the use of Rx in children with FR/SDNS.

Material and methods: A review of the available medical literature for the last twenty years has been done.

Conclusion: Treatment with Rx is effective in patients with complicated FR/SDNS but requires close monitoring (clinical and laboratory).

Key words: frequent relapsing nephrotic syndrome, steroid dependent nephrotic syndrome, rituximab, childhood

Bibliography

Address for correspondence:

SBALDB “Prof. Ivan Mitev” – Sofia, Children’s Nephrology

and Hemodialysis Clinic, MU – Sofia

11, “Аcad. Ivan Geshov”, Str.

1606, Sofia

e-mail: galiazlatanova@abv.bg