タナカ　リョウジロウ   Ryojiro Tanaka   田中　亮二郎    所属   川崎医科大学  医学部 臨床医学　小児科学    職種   特任教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Efficacy of rituximab therapy against intractable steroid-resistant nephrotic syndrome.
掲載誌名	正式名：Pediatrics international : official journal of the Japan Pediatric Society 略　 称：Pediatr Int ISSNコード：1442200X/13288067
掲載区分	国外
巻・号・頁	58(10),pp.1003-1008
著者・共著者	Taku Nakagawa, Atsutoshi Shiratori, Yasuo Kawaba, Kyoko Kanda, Ryojiro Tanaka
発行年月	2016/10
概要	BACKGROUND:Some cases of childhood steroid-resistant nephrotic syndrome (SRNS) are intractable. We examined the cases of three patients with SRNS resistant to various treatment, but who achieved complete remission after being treated with rituximab (RTX) followed by methylprednisolone pulse (MP) therapy.METHODS:A retrospective chart review of all new-onset SRNS in the period from January 1997 to December 2013 was performed. Three of the 13 patients who received conventional treatment continued to have NS for >6 months, despite also being treated with immunosuppressants and receiving frequent albumin treatment. In addition, two of the patients received plasma exchange therapy, but it was ineffective. Therefore, RTX was used once a week for 4 weeks, followed by several courses of MP therapy.RESULTS:Two of the three intractable SRNS patients achieved complete remission after treatment with RTX followed by MP therapy, and the remaining patient achieved incomplete remission after the first round of this treatment. That patient subsequently achieved complete remission after the second round of the treatment. RTX did not cause any serious side-effects, and all three patients had normal renal function at the final observation.CONCLUSIONS:Complete remission was achieved in all 13 SRNS patients. RTX followed by MP therapy might be effective against SRNS refractory to conventional treatments and requiring frequent albumin treatment. Prospective clinical study examining the effectiveness and safety of this approach is required.
DOI	10.1111/ped.12948
PMID	26865241