A. Kirpalani, G. Filler, J. Grimmer, Vladimir Belostosky, S. Arora, Ajay P Sharma
{"title":"利妥昔单抗和霉酚酸酯治疗小儿难治性肾病综合征后的类固醇再试验","authors":"A. Kirpalani, G. Filler, J. Grimmer, Vladimir Belostosky, S. Arora, Ajay P Sharma","doi":"10.14740/WJNU267W","DOIUrl":null,"url":null,"abstract":"Steroid-resistant nephrotic syndrome (SRNS) is a challenging condition. In pediatric SRNS, cyclosporine is the first-line treatment choice, with approximately 60% success rate. In cyclosporine-resistant disease, treatment modalities such as cyclophosphamide, mycophenolate mofetil (MMF), tacrolimus, vincristine, galactose, plasmapheresis and rituximab have been tried with variable success. In this paper, we report a patient with SRNS who remained resistant to all the above stated medications except a moderate response to rituximab. After rituximab, MMF re-initiation did not induce further improvement. Prednisone retrial thereafter induced a prompt remission. The significance of this finding in context with current literature has been discussed. World J Nephrol Urol. 2016;5(2):33-36 doi: http://dx.doi.org/10.14740/wjnu267w","PeriodicalId":91634,"journal":{"name":"World journal of nephrology and urology","volume":"5 1","pages":"33-36"},"PeriodicalIF":0.0000,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Steroid Retrial After Rituximab and Mycophenolate Mofetil in Pediatric Refractory Nephrotic Syndrome\",\"authors\":\"A. Kirpalani, G. Filler, J. Grimmer, Vladimir Belostosky, S. Arora, Ajay P Sharma\",\"doi\":\"10.14740/WJNU267W\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Steroid-resistant nephrotic syndrome (SRNS) is a challenging condition. In pediatric SRNS, cyclosporine is the first-line treatment choice, with approximately 60% success rate. In cyclosporine-resistant disease, treatment modalities such as cyclophosphamide, mycophenolate mofetil (MMF), tacrolimus, vincristine, galactose, plasmapheresis and rituximab have been tried with variable success. In this paper, we report a patient with SRNS who remained resistant to all the above stated medications except a moderate response to rituximab. After rituximab, MMF re-initiation did not induce further improvement. Prednisone retrial thereafter induced a prompt remission. The significance of this finding in context with current literature has been discussed. World J Nephrol Urol. 2016;5(2):33-36 doi: http://dx.doi.org/10.14740/wjnu267w\",\"PeriodicalId\":91634,\"journal\":{\"name\":\"World journal of nephrology and urology\",\"volume\":\"5 1\",\"pages\":\"33-36\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World journal of nephrology and urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14740/WJNU267W\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World journal of nephrology and urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14740/WJNU267W","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Steroid Retrial After Rituximab and Mycophenolate Mofetil in Pediatric Refractory Nephrotic Syndrome
Steroid-resistant nephrotic syndrome (SRNS) is a challenging condition. In pediatric SRNS, cyclosporine is the first-line treatment choice, with approximately 60% success rate. In cyclosporine-resistant disease, treatment modalities such as cyclophosphamide, mycophenolate mofetil (MMF), tacrolimus, vincristine, galactose, plasmapheresis and rituximab have been tried with variable success. In this paper, we report a patient with SRNS who remained resistant to all the above stated medications except a moderate response to rituximab. After rituximab, MMF re-initiation did not induce further improvement. Prednisone retrial thereafter induced a prompt remission. The significance of this finding in context with current literature has been discussed. World J Nephrol Urol. 2016;5(2):33-36 doi: http://dx.doi.org/10.14740/wjnu267w
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
