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Summary
Minimal change disease (MCD) is usually steroid sensitive, although in case of steroid dependent and multiple relapses we can struggle with different immunosuppressive agents, sometimes with no response. Rituximab has been emerging as an alternative therapeutic option.
We describe a case of a young patient with MCD that had frequent relapses and steroid dependency, with no response to several immunosuppressive agents during 15 years of disease. He was kept under high-dose steroids and ciclosporin. He started treatment with rituximab (two administrations of 1 g 2 weeks apart, repeating after 6 months). The steroids dose was gradually reduced and the ciclosporin was stopped. During the entire 2 years follow-up period, he remained in remission and had no adverse events.
This remarkable outcome reinforces the option of using rituximab in difficult cases, allowing the reduction of steroid burden and its adverse effects, which is of extreme importance, especially in young patients.
- renal system
- nephrotic syndrome
- therapeutic indications
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Footnotes
Contributors HP contributed to the article with the conception of the manuscript, to the acquisition, analysis and interpretation of data and drafting the work. NO contributed to the article with the conception of the manuscript, with bibliographic research and revising it critically for important intellectual content. FC contributed to the article with the conception of the manuscript, to revising it critically for important intellectual content and to the approval of the final version of the manuscript. RA contributed to the article revising it critically for important intellectual content and to the approval of the final version of the manuscript.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.