NDT Advance Access originally published online on November 2, 2007
Nephrology Dialysis Transplantation 2008 23(1):377-380; doi:10.1093/ndt/gfm592
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© The Author [2007].
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Rapid remission of steroid and mycophenolate mofetil (mmf)-resistant minimal change nephrotic syndrome after rituximab therapy
1Department of Medicine, Division of Nephrology and 2Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
Correspondence to: Stanley C. Jordan, MD, Professor of Pediatrics & Medicine, Director, Nephrology & Transplant Immunology, Medical Director, Kidney Transplant Program, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 490W, Los Angeles CA 90048, USA. Email: sjordan@cshs.org
Keywords: focal segmental glomerulosclerosis; minimal change disease; nephrotic syndrome; rituximab; steroid resistance
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Introduction |
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Minimal change nephrotic syndrome (MCNS) is the most common cause of nephrotic syndrome (NS) in children. However, this disease also occurs in adults as an idiopathic abnormality, in association with lymphoid and other neoplasms and with administration of therapeutic agents. The pathogenesis of MCNS is not completely understood, but there is now consensus that a glomerular permeability factor in some cases is responsible for the clinical and pathological features of the disease [1–4]. Data to support this include isolation of a permeability factor produced by clonal expansion of T-cells that alters albumin permeability of rat glomerular epithelial cell monolayers [3] and induces proteinuria when injected into rats [4]. Other investigators suggest MCNS is a systemic disorder of T-cell function and cell-mediated immunity [1,2]. However, the role of T-cells and their products in the development of MCNS is not defined.
Until
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