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Pediatric Nephrology

Erschienen in:

01.09.2013 | Brief Report

Fulminant viral myocarditis after rituximab therapy in pediatric nephrotic syndrome

verfasst von: Anne-Laure Sellier-Leclerc, Emre Belli, Valérie Guérin, Peter Dorfmüller, Georges Deschênes

Erschienen in: Pediatric Nephrology | Ausgabe 9/2013

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Abstract

Background

We report a 7-year-old boy with high-degree steroid-dependent idiopathic nephrotic syndrome (SDNS) who went into remission with rituximab (RTX) maintenance therapy.

Case-Diagnosis/Treatment

Four months after this patient received his first RTX infusion, there was a progressive and sustained decrease of immunoglobulin (Ig)G and IgM levels. Thirteen months after the initiation of RTX therapy he was in sustained remission without any steroid or oral immunosuppressive therapy; however, B cell depletion was still present. At this time he developed a fulminant myocarditis due to enterovirus. Despite aggressive treatment and the administration of intravenous polyvalent immunoglobulins there was no clinical improvement. He successfully underwent heart transplant surgery.

Conclusions

We conclude that B cell depletion with RTX is efficacious in the treatment of paediatric SDNS but that it may be associated with severe infectious complications. Therefore, we recommend a close monitoring of Ig levels in children who have received RTX therapy and a supplementation with intravenous Ig as soon as the Ig levels fall below the lower limit of the normal range

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Titel: Fulminant viral myocarditis after rituximab therapy in pediatric nephrotic syndrome
verfasst von: Anne-Laure Sellier-Leclerc
Emre Belli
Valérie Guérin
Peter Dorfmüller
Georges Deschênes
Publikationsdatum: 01.09.2013
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Nephrology / Ausgabe 9/2013
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-013-2485-9

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Fulminant viral myocarditis after rituximab therapy in pediatric nephrotic syndrome

Abstract

Background

Case-Diagnosis/Treatment

Conclusions

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

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Abstract

Background

Case-Diagnosis/Treatment

Conclusions

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