利妥昔单抗治疗激素和环磷酰胺抵抗的微小病变型肾病综合征达到长期完全缓解相关病例回顾和总结

本文报道1例患有微小病变型肾病综合征的20岁男性患者,初始激素治疗有效,但由于不遵医嘱突然自行停药后复发,并且出现激素和环磷酰胺抵抗,在使用利妥昔单抗2次后病情很快缓解,即使CD19细胞恢复,患者的完全缓解时间亦达到35个月。文献回顾和总结提示,在CD19细胞恢复后,利妥昔单抗仍然对部分儿童和成人的复发和难治性微小病变型肾病综合征有作用。

Retrospect and summary of relative cases of sustained complete remission of nephrotic syndrome with steroid-and-cyclophosphamide-resistant minimal-change disease by rituximab therapy

The article reports one case of nephrotic syndrome resulted from minimal-change disease in a 20-year-old male;predisone worked well initially,however,the disease relapsed and became steroid-and-cyclophosphamide-resistant after he stopped medicine administration suddenly,but responded rapidly to two doses of rituximab therapy.Complete disease remission has been sustained up to last follow-up (35 months) despite CD19 recovery.Literature retrospect and summary suggested that rituximab might have effect on some recurrent and/or refractory minimal-change disease in adults and children after CD19 cell recovery.