Rituximab Use in the Management of Childhood Nephrotic Syndrome
Childhood nephrotic syndrome is a challenging and often persistent renal disorder, and its incidence varies between different ethnicities and regions. Corticosteroids have been the main treatment for decades and are effective in most children with idiopathic NS, although 10–15% of these children bec...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-05-01
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| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/article/10.3389/fped.2019.00178/full |
| _version_ | 1818552321937768448 |
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| author | Mahmoud Kallash William E. Smoyer John D. Mahan |
| author_facet | Mahmoud Kallash William E. Smoyer John D. Mahan |
| author_sort | Mahmoud Kallash |
| collection | DOAJ |
| description | Childhood nephrotic syndrome is a challenging and often persistent renal disorder, and its incidence varies between different ethnicities and regions. Corticosteroids have been the main treatment for decades and are effective in most children with idiopathic NS, although 10–15% of these children become steroid resistant. Furthermore, some initially steroid sensitive children follow a steroid dependent or frequently relapsing course and are therefore at increased risk for developing steroid toxicity. In such children, alternative immunosuppressive medications are used to induce and/or maintain remission of NS. One such drug, rituximab, is a monoclonal antibody directed against the B lymphocyte CD20 marker which induces depletion of B cells, and has shown promising results in the management of NS in children. In this review, we summarize recent studies on the efficacy and safety of rituximab in the different types of childhood nephrotic syndrome, the known and potential mechanisms of action of rituximab, its possible complications and side effects, and the available and potential biomarkers of rituximab activity. |
| first_indexed | 2024-12-12T09:11:41Z |
| format | Article |
| id | doaj.art-9ca744316f684b4391be5d1024012367 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-12-12T09:11:41Z |
| publishDate | 2019-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-9ca744316f684b4391be5d10240123672022-12-22T00:29:29ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602019-05-01710.3389/fped.2019.00178452297Rituximab Use in the Management of Childhood Nephrotic SyndromeMahmoud KallashWilliam E. SmoyerJohn D. MahanChildhood nephrotic syndrome is a challenging and often persistent renal disorder, and its incidence varies between different ethnicities and regions. Corticosteroids have been the main treatment for decades and are effective in most children with idiopathic NS, although 10–15% of these children become steroid resistant. Furthermore, some initially steroid sensitive children follow a steroid dependent or frequently relapsing course and are therefore at increased risk for developing steroid toxicity. In such children, alternative immunosuppressive medications are used to induce and/or maintain remission of NS. One such drug, rituximab, is a monoclonal antibody directed against the B lymphocyte CD20 marker which induces depletion of B cells, and has shown promising results in the management of NS in children. In this review, we summarize recent studies on the efficacy and safety of rituximab in the different types of childhood nephrotic syndrome, the known and potential mechanisms of action of rituximab, its possible complications and side effects, and the available and potential biomarkers of rituximab activity.https://www.frontiersin.org/article/10.3389/fped.2019.00178/fullnephrotic syndromerituximabpediatricsteroid sensitive nephrotic syndromesteroid resistant nephrotic syndrome |
| spellingShingle | Mahmoud Kallash William E. Smoyer John D. Mahan Rituximab Use in the Management of Childhood Nephrotic Syndrome Frontiers in Pediatrics nephrotic syndrome rituximab pediatric steroid sensitive nephrotic syndrome steroid resistant nephrotic syndrome |
| title | Rituximab Use in the Management of Childhood Nephrotic Syndrome |
| title_full | Rituximab Use in the Management of Childhood Nephrotic Syndrome |
| title_fullStr | Rituximab Use in the Management of Childhood Nephrotic Syndrome |
| title_full_unstemmed | Rituximab Use in the Management of Childhood Nephrotic Syndrome |
| title_short | Rituximab Use in the Management of Childhood Nephrotic Syndrome |
| title_sort | rituximab use in the management of childhood nephrotic syndrome |
| topic | nephrotic syndrome rituximab pediatric steroid sensitive nephrotic syndrome steroid resistant nephrotic syndrome |
| url | https://www.frontiersin.org/article/10.3389/fped.2019.00178/full |
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