Use of rituximab in pediatric patients with steroidresistant nephrotic syndrome. A single center study

Authors

  • Lina María Serna-Higuita Pablo Tobón Uribe Hospital. University of Antioquia
  • Juan José Vanegas-Ruiz Pablo Tobón Uribe Hospital. University of Antioquia
  • Ana Katherina Serrano-Gayubo University of Antioquia
  • Catalina Vélez-Echeverri Pablo Tobón Uribe Hospital. University of Antioquia
  • Carolina Lucía Ochoa-García University of Antioquia
  • Luisa Fernanda Rojas-Rosas University of Antioquia
  • Richard Baquero-Rodríguez University of Antioquia
  • John Fredy Nieto-Ríos Pablo Tobon Uribe Hospital. University of Antioquia
  • Catalina Ocampo-Kohn Pablo Tobon Uribe Hospital. University of Antioquia
  • Arbey Aristizábal-Alzate Pablo Tobon Uribe Hospital. University of Antioquia
  • Juan Pablo Orozco-Forero Pontifical Bolivarian University
  • Jesús Antonio Flórez University of Antioquia
  • Jhon Jairo Zuleta-Tobón Pablo Tobón Uribe Hospital. University of Antioquia
  • Gustavo Adolfo Zuluaga-Valencia Pablo Tobon Uribe Hospital. University of Antioquia

DOI:

https://doi.org/10.17533/udea.iatreia.16785

Keywords:

chronic renal disease, immunosuppressive agents, mycophenolic acid, nephrotic syndrome

Abstract

Introduction: Steroids are the cornerstone of therapy for nephrotic syndrome (NS) with a remission rate as high as 90%. In patients who do not respond to them or are steroid dependent, other immunosuppressive drugs have been used. Although rituximab use in NS is off-label, many authors have published their experience with it.

Objective and methods: To describe retrospectively a group of seven children with nephrotic syndrome, either steroid-dependent (SDNS) or steroid- resistant (SRNS), treated with rituximab and mycophenolate, at Pablo Tobón Uribe Hospital, in Medellín, Colombia.

Results: Two patients with SDNS and five with SRNS were evaluated; median age at diagnosis was 2 years (p25-75: 1-5); six months after treatment with rituximab there was reduction in proteinuria (93%), in the steroid dose (100%) and in the relapse episodes. However, proteinuria reappeared 12 months after treatment.

Conclusion: During the first year after rituximab treatment of NS there is reduction in proteinuria and in the steroid dose, but thereafter there is relapse. It is suggested to carry out another study using a second dose of rituximab one year after the first one.

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Author Biographies

Lina María Serna-Higuita, Pablo Tobón Uribe Hospital. University of Antioquia

Department of Pediatrics and Childcare, Faculty of Medicine, University of Antioquia. Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, University of Antioquia, Medellín, Colombia.

 

Juan José Vanegas-Ruiz, Pablo Tobón Uribe Hospital. University of Antioquia

Department of Pediatrics and Childcare, Faculty of Medicine, University of Antioquia, Medellín, Colombia. Nephrology and Transplantation Group, Hospital Pablo Tobón Uribe, Medellín, Colombia.

Ana Katherina Serrano-Gayubo, University of Antioquia

Department of Pediatrics and Childcare, Pediatric Nephrology Section, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia.

Catalina Vélez-Echeverri, Pablo Tobón Uribe Hospital. University of Antioquia

Department of Pediatrics and Childcare, Faculty of Medicine, Universidad de Antioquia. Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, Universidad de Antioquia, Medellín, Colombia. 

Carolina Lucía Ochoa-García, University of Antioquia

Department of Pediatrics and Childcare, Pediatric Nephrology Section, Faculty of Medicine, Universidad de Antioquia. Pediatric Nephrologist, DaVita Health Care, Medellín, Colombia.

Luisa Fernanda Rojas-Rosas, University of Antioquia

Department of Pediatrics and Childcare, Pediatric Nephrology Section, Faculty of Medicine, Universidad de Antioquia. Pediatric Nephrologist, RTS-Baxter, Medellín, Colombia. 

Richard Baquero-Rodríguez, University of Antioquia

Department of Pediatrics and Childcare, Pediatric Nephrology Section, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia. 

John Fredy Nieto-Ríos, Pablo Tobon Uribe Hospital. University of Antioquia

Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, Universidad de Antioquia, Medellín, Colombia.  

Catalina Ocampo-Kohn, Pablo Tobon Uribe Hospital. University of Antioquia

Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, Universidad de Antioquia, Medellín, Colombia.

Arbey Aristizábal-Alzate, Pablo Tobon Uribe Hospital. University of Antioquia

Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, Universidad de Antioquia, Medellín, Colombia.

Juan Pablo Orozco-Forero, Pontifical Bolivarian University

Department of Pediatrics, Universidad Pontificia Bolivariana, Medellín, Colombia.

Jesús Antonio Flórez, University of Antioquia

Department of Pediatrics and Childcare, Pediatric Nephrology Section, Faculty of Medicine, Universidad de Antioquia, Medellín, Colombia. 

Jhon Jairo Zuleta-Tobón, Pablo Tobón Uribe Hospital. University of Antioquia

Clinical Epidemiologist, Hospital Pablo Tobón Uribe. Teacher, Master of Clinical Sciences, Universidad de Antioquia, Medellín, Colombia. 

Gustavo Adolfo Zuluaga-Valencia, Pablo Tobon Uribe Hospital. University of Antioquia

Nephrology and Transplantation Group, Pablo Tobón Uribe Hospital, Universidad de Antioquia, Medellín, Colombia.

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Published

2014-12-29

How to Cite

1.
Serna-Higuita LM, Vanegas-Ruiz JJ, Serrano-Gayubo AK, Vélez-Echeverri C, Ochoa-García CL, Rojas-Rosas LF, Baquero-Rodríguez R, Nieto-Ríos JF, Ocampo-Kohn C, Aristizábal-Alzate A, Orozco-Forero JP, Flórez JA, Zuleta-Tobón JJ, Zuluaga-Valencia GA. Use of rituximab in pediatric patients with steroidresistant nephrotic syndrome. A single center study. Iatreia [Internet]. 2014 Dec. 29 [cited 2025 Feb. 2];28(1):35-43. Available from: https://revistas.udea.edu.co/index.php/iatreia/article/view/16785

Issue

Vol. 28 No. 1

Section

Original research

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