Abstract
There are some reports on the cases with child refractory nephrotic syndrome effectively treated with rituximab. We report a 7-year-old boy with steroid-dependent nephrotic syndrome (minimal change), who developed severe neutropenia (neutrophil count 0%) with fever three months after the administration of rituximab (375mg/m2/dose) four times. As to neutropenia, the patient was treated with G-CSF, and rapidly recovered. Some cases of delayed-onset (1 to 5 months later) severe neutropenia have been reported in patients with other diseases such as lymphoma. Many of them were treated with G-CSF or naturally recovered. There, however, is a case of long-lasting neutropenia for one year. As far as reviewed in the literature, there are no reports on cases of nephrotic syndrome with rituximab-related delayed-onset neutropenia. Rituximab treatment will be widely used to child refractory nephrotic syndrome in the near future. When treated with rituximab, those patients must be carefully followed at least for one year regarding delayed-onset severe neutropenia.
