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利妥昔单抗维持治疗期间儿童起病的激素依赖性肾病综合征患者成功妊娠。

Successful Pregnancies in a Patient with Childhood-onset Steroid-dependent Nephrotic Syndrome during Rituximab Maintenance Therapy.

机构信息

Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine, Japan.

Department of Life Science, Akita University Graduate School of Engineering Science, Japan.

出版信息

Intern Med. 2021 Sep 15;60(18):2985-2989. doi: 10.2169/internalmedicine.6633-20. Epub 2021 Mar 29.

DOI:10.2169/internalmedicine.6633-20
PMID:33776000
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8502647/
Abstract

There are an increasing number of reports on the safe use of rituximab (RTX), a chimeric anti-CD20 monoclonal antibody, in pregnant women with hematological malignancies or refractory autoimmune diseases. In 2014, the use of RTX for patients with complicated steroid-dependent nephrotic syndrome (SDNS) was approved in Japan. We herein report a woman with childhood-onset complicated SDNS due to focal and segmental glomerulosclerosis, who had two successful pregnancies while receiving RTX maintenance therapy. No adverse complications were observed during the pregnancies, and she delivered healthy newborns. This case suggested that RTX may be used safely in pregnant women complicated with SDNS.

摘要

越来越多的报告表明，在患有血液系统恶性肿瘤或难治性自身免疫性疾病的孕妇中，使用利妥昔单抗（RTX）是安全的。RTX 是一种嵌合抗 CD20 单克隆抗体。2014 年，RTX 获批用于治疗伴有复杂型激素依赖性肾病综合征（SDNS）的患者。本文报告了一例儿童起病的伴有局灶节段性肾小球硬化的复杂型 SDNS 患者，该患者在接受 RTX 维持治疗的同时成功妊娠两次。两次妊娠期间均未发生不良并发症，患者顺利分娩健康新生儿。该病例提示，RTX 可能可安全用于伴有 SDNS 的孕妇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f6/8502647/5ca5d3e8ca8f/1349-7235-60-2985-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f6/8502647/bceb189a7409/1349-7235-60-2985-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f6/8502647/5ca5d3e8ca8f/1349-7235-60-2985-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f6/8502647/bceb189a7409/1349-7235-60-2985-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/66f6/8502647/5ca5d3e8ca8f/1349-7235-60-2985-g002.jpg

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2
Incidence of remission and relapse of proteinuria, end-stage kidney disease, mortality, and major outcomes in primary nephrotic syndrome: the Japan Nephrotic Syndrome Cohort Study (JNSCS).原发性肾病综合征中蛋白尿缓解和复发、终末期肾病、死亡率以及主要结局的发生率：日本肾病综合征队列研究（JNSCS）。
Clin Exp Nephrol. 2020 Jun;24(6):526-540. doi: 10.1007/s10157-020-01864-1. Epub 2020 Mar 7.
3
2020 American College of Rheumatology Guideline for the Management of Reproductive Health in Rheumatic and Musculoskeletal Diseases.
2020 年美国风湿病学会风湿病和肌肉骨骼疾病生殖健康管理指南。
Arthritis Rheumatol. 2020 Apr;72(4):529-556. doi: 10.1002/art.41191. Epub 2020 Feb 23.
4
Use of Rituximab in NHL Malt Type Pregnant in I° Trimester for Two Times.利妥昔单抗在妊娠早期I度的非霍奇金淋巴瘤麦芽型孕妇中的两次使用。
Open Med (Wars). 2019 Nov 12;14:757-760. doi: 10.1515/med-2019-0087. eCollection 2019.
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Neurol Neuroimmunol Neuroinflamm. 2019 Nov 12;7(1). doi: 10.1212/NXI.0000000000000637. Print 2020 Jan.
6
[Successful treatment with preceding low-intensity chemotherapy in a primary mediastinal large B cell lymphoma patient diagnosed at 11 weeks of pregnancy].
Rinsho Ketsueki. 2019;60(2):112-117. doi: 10.11406/rinketsu.60.112.
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