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Pediatric Nephrology

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01-03-2020 | Rituximab | Original Article

Immunoglobulin serum levels in rituximab-treated patients with steroid-dependent nephrotic syndrome

Authors: Cyrielle Parmentier, Jean-Daniel Delbet, Stéphane Decramer, Olivia Boyer, Julien Hogan, Tim Ulinski

Published in: Pediatric Nephrology | Issue 3/2020

Abstract

Background

Rituximab (RTX) is efficient in steroid-dependent nephrotic syndrome (SDNS) in pediatric and adult patients. The aim of this study is to describe hypogammaglobulinemia as a side effect of RTX treatment.

Methods

All pediatric patients (< 18 years old) of four French pediatric nephrology centers who received RTX for SDNS between 2010 and 2015 have been included. Clinical and biological data have been analyzed retrospectively before, during, and after RTX treatment. Hypogammaglobulinemia was defined as an IgG level < − 2 standard deviations for patient age.

Results

A total of 107 pediatric patients have been included, 65.9% were boys, median age at nephrotic syndrome diagnosis was 3.1 interquartile range [IQ 2.24–5.45] years and age at RTX introduction was 11.7 [IQ 8.6–14.2] years. Twenty-one patients had hypogammaglobulinemia before the initiation of RTX. Of the patients, 25/86 had at least one hypogammaglobulinemia during B cell depletion or after B cell recovery while IgG levels at initiation were normal with a persisting hypogammaglobulinemia for 13 patients 1 year after B cell recovery. Patients who developed hypogammaglobulinemia were younger at RTX initiation with a median age of 8.2 years [IQ 6.3–12.4]. Among all the 46 patients with hypogammaglobulinemia during follow-up, 13 had a concomitant infection.

Conclusions

Hypogammaglobulinemia is a frequent complication of RTX treatment in younger children treated for SDNS. The use of RTX in children has to be carefully evaluated and their clinical and biological follow-up should be adapted to the age-dependent risk profile for hypogammaglobulinemia.

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Title: Immunoglobulin serum levels in rituximab-treated patients with steroid-dependent nephrotic syndrome
Authors: Cyrielle Parmentier
Jean-Daniel Delbet
Stéphane Decramer
Olivia Boyer
Julien Hogan
Tim Ulinski
Publication date: 01-03-2020
Publisher: Springer Berlin Heidelberg
Keywords: Rituximab
Nephrotic Syndrome
Rituximab
Published in: Pediatric Nephrology / Issue 3/2020
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-019-04398-1

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Immunoglobulin serum levels in rituximab-treated patients with steroid-dependent nephrotic syndrome

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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