Abstract
Patients with refractory nephrotic syndrome, such as steroid-dependent, frequently-relapsing or steroid-resistant nephrotic syndrome, are frequently complicated with serious adverse effects of steroid therapy caused by long-term use. In particular, bone complications such as failure to thrive (short height), osteoporosis, osteonecrosis of the femoral head and vertebral bone fractures are irreversible and compromise the patients' quality of life.
We administered rituximab to four patients with refractory nephrotic syndrome who suffered from osteonecrosis or vertebral bone fractures. After the rituximab therapy, all four patients were able to discontinue steroid therapy, thereby preventing new bone complications. Their bone mineral density had remarkably improved. In addition, the patients recovered the ability to walk without assistance or a stick. No severe adverse effects of rituximab were experienced.
Rituximab is a hopeful agent for children with severe bone complications. However, we should be aware of any risks of rituximab therapy.
