Abstract
Original language | English |
---|---|
Pages (from-to) | 3035-3042 |
Number of pages | 8 |
Journal | Pediatric nephrology (Berlin, Germany) |
Volume | 38 |
Issue number | 9 |
Early online date | 2023 |
DOIs | |
Publication status | Published - Sept 2023 |
Keywords
- Children
- Hypogammaglobulinemia
- Nephrotic syndrome
- Rituximab
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In: Pediatric nephrology (Berlin, Germany), Vol. 38, No. 9, 09.2023, p. 3035-3042.
Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Rituximab-associated hypogammaglobulinemia in children with idiopathic nephrotic syndrome
T2 - results of an ESPN survey
AU - Zurowska, Aleksandra
AU - Drozynska-Duklas, Magdalena
AU - Topaloglu, Rezan
AU - Bouts, Antonia
AU - Boyer, Olivia
AU - Shenoy, Mohan
AU - Vivarelli, Marina
AU - on behalf of ESPN Glomerulonephritis Working Group
AU - Alpay, H.
AU - Andersen, R.
AU - Ariceta, G.
AU - Atmış, B.
AU - Bayrakçı, U. S.
AU - Esrea, B.
AU - Baudouin, V.
AU - Bervina, N.
AU - Benetti, E.
AU - Berard, E.
AU - Bjerre, A.
AU - Christian, M.
AU - Couderc, A.
AU - Dehoorne, J.
AU - Deschenes, G.
AU - Dossier, C.
AU - Düşünsel, R.
AU - Ekinci, Z.
AU - Emma, F.
AU - Espinoza, L.
AU - Gianviti, A.
AU - Herrero Goñi, M.
AU - Guido, G.
AU - Ghio, L.
AU - Groothoff, J.
AU - Hacıhamdioğlu, D.
AU - Espino Hernández, M.
AU - Jankauskiene, A.
AU - Kagan, M.
AU - Kemper, M.
AU - Kovacevic, M.
AU - Kohl, S.
AU - Kramar, R. T.
AU - López-González, M.
AU - Aris, A. M.
AU - Maringhini, S.
AU - Marlais, M.
AU - Melgosa, M.
AU - Mitsioni, A.
AU - Montini, G.
AU - Moczulska, A.
AU - Murer, L.
AU - Obukhova, V.
AU - Pecoraro, C.
AU - van Wijk, J. A. E.
N1 - Funding Information: Endén K.: Department of Paediatrics, Tampere University Hospital, Tampere, Finland; Oh J.: University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Tsygin A.: Federal State Budgetary Institution “Scientific Centre of Children Health” under the Russian Academy of Medical Sciences, Moscow, Russia; Grenda R.: The Children’s Memorial Health Institute, Warsaw, Poland; Raes A.: Department of Pediatric Nephrology, Ghent University Hospital, 9000 Ghent, Belgium; Van Hoeck Koen J.M.: Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium; Adams B.: Hôpital Universitaire des Enfants Reine Fabiola HUDERF·Department of Nephrology-dialysis; Aksenova M.: Scientific Clinical Institution of Pediatrics of Russian Medical University, Moscow·nephrology; Ranchin B.: Pediatric Nephrology Unit, Hôpital Femme Mere Enfant, Hospices Civils de Lyon, Lyon, France; Hooman N.: Aliasghar Clinical Research Development Center, Alkiasghar Children Hospital, University of Medical Sciences (IUMS) Tehera, Iran; Ogarek I.: Department of Pediatric Nephrology and Hypertension CMUJ in Cracow, Poland; Seeman T.: Department of Pediatrics and Biomedical Center, 2nd Faculty of Medicine and Faculty of Medicine in Pilsen, Charles University in Prague, Czech Republic; Fila M.: Centre Hospitalier Universitaire de Montpellier , Department de pediatrie; Oni L.: Department of Paediatric Nephrology, Liverpool Health Partners, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool, UK; Mir S.: Department of Pediatrics, Pediatric Nephrology Units, Faculty of Medicine, Ege University, Izmir, Turkey; Novo R.: Pediatric Nephrology Unit, Hôpital Jeanne de Flandre, Centre Hospitalier Universitaire de Lille, Lille, France; Stabouli S.: 1st Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University Thessaloniki, Hippokratio Hospital; Vara-Martín J.: Pediatric Nephrology, Pediatrics, University Hospital 12 Octubre, Madrid, Spain; van Wijk J.A.E.: Department of Pediatric Nephrology, VU University Medical Center, Amsterdam; Ehren R.: Children’s and Adolescents’ Hospital, Pediatric Nephrology, University of Cologne, Germany; Bekassy Z.: Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden; Herthelius M.: Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden; Becherucci F.: Nephrology and Dialysis Unit, Meyer Children’s University Hospital, Florence, Italy; Shasha-Lavsky H.: Pediatric Nephrology Unit, Galilee Medical Center, Nahariya, Israel; Santos F.: Hospital Universitario Central de Asturias (HUCA), University of Oviedo, Oviedo, Spain; Feldkötter M.: Department of Pediatrics, Division of Pediatric Nephrology, University Children’s Hospital Zurich, Zurich, Switzerland; Pańczyk-Tomaszewska M.: Medical University of Warsaw, Poland: Department of Pediatrics and Nephrology; Harambat J.: Department of Pediatric Nephrology, Centre Hospitalier Universitaire de Bordeaux Groupe hospitalier Pellegrin, Bordeaux, France; Grima D.: Cornerstone Research Group, Burlington, Ontario, Canada; Gökçe I.: Department of Pediatric Nephrology, Marmara University School of Medicine, Istanbul, Turkey; Teixeira A.: Centro Materno-Infantil do Norte, Centro Hospitalar do Porto, Porto, Portugal; Licht C.: Department of Pediatric Nephrology, The Hospital for Sick Children, Toronto, Canada; Schmidt I.M.: Department of Paediatrics and Adolescent Medicine, Juliane Marie Centre, Rigshospitalet University Hospital, Copenhagen, Denmark; Brandström P.: Pediatric UroNephrology Center, The Queen Silvia Children’s Hospital, The Sahlgrenska Academy at the University of Gothenburg, Sweden; Dinçel N.: Department of Pediatric Nephrology, University of Health Sciences Dr. Behc¸et Uz Child Disease and Pediatric Surgery Training and Research Hospital, İzmir, Turkey. Collaborators: Members of ESPN Glomerulonephritis Working Group: Alpay H. – Marmara University, Istanbul, Turkey Andersen R. - Aarhus University Hospital, Denmark. Ariceta G. - Hospital MaternoInfantil de la Vall d’Hebron, Barcelona, Spain Atmış B. - Cukurova University Faculty of Medicine, Adana, Turkey. Bayrakçı U.S. - Ankara Yıldırım Beyazıt Unıversity Faculty of Medicine, Ankara, Turkey Esrea B. - Baskent University Hospital, Ankara, Turkey Baudouin V. - Robert Debré Hospital, APHP, Paris, France. Bervina N. - Orenburg Regional Children's Hospital , Nephrology Department Benetti E. - AOP-University of Padova, Italy Berard E. - Hôpitaux pédiatriques universitaires de Nice, Nice, France, Bjerre A. - Oslo University Hospital, Rikshospitalet, Oslo, Norway. Bouts A. - Amsterdam University, The Netherlands. Christian M. - Nottingham Children's Hospital at the QMC, UK Couderc A. - APHP, Hôpital Robert-Debré, Paris, France Dehoorne J. - Ghent University, Gent, Belgium. Deschenes G. - Paris University Hospital Robert Debré, Paris, France. Dossier C. - APHP, Hôpital Robert-Debré, Paris, France. Düşünsel R. - Erciyes University Faculty of Medicine, Kayseri, Turkey Ekinci Z. - Kocaeli Academy for Solidarity, Kocaeli, Turkey. Emma F. - Bambino Gesù Children's Hospital, IRCCS, Rome, Italy; Espinoza L. - Servicio de Nefrología Pediátrica, Hospital La Paz, Madrid, España Gianviti A. - Children's Hospital Bambino Gesù, IRCCS, Rome, Italy. Herrero Goñi M. - Hospital de Cruces, Baracaldo, Spain. Guido G. - Ospedale S. Eugenio, Roma, Italia. Ghio L. - Fondazione Ca’ Granda, IRCCS Ospedale Maggiore, Policlinico Milano, Italy Groothoff J. - Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, The Netherlands. Hacıhamdioğlu D.Ö. - MedicalPark Goztepe Hospital, Istanbul, Turkey. Espino Hernández M. - Pediatrics, University Hospital 12 Octubre, Madrid, Spain. Jankauskiene A. - Pediatric Center, Vilnius University, Vilnius, Lithuania Kagan M. - Orenburg Regional Children’s Hospital, Orenburg, Russia; Kemper M. - University Hospital Hamburg-Eppendorf, Hamburg, Germany; Kovacevic M. - Institute for Child and Youth Health Care in Novi Sad, Serbia Kohl S. - University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Kramar R.T. - Karolinska Institutet, Sweden López-González M. - University Hospital Vall d'Hebron, Barcelona, Spain Aris A.M. - Madrid Hospital Vall d’Hebron, Barcelona, Spain Maringhini S. - Ospedale dei Bambini “G. Di Cristina” A.R.N.A.S. Palermo, Italy Marlais M. - Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK Melgosa M. - La Paz University Hospital, Madrid, Spain. Mitsioni A. - P. & A. Kyriakou Children’s Hospital, Athens, Greece Montini G. - University of Milan, Ospedale Maggiore Policlinico, Milano, Italy Moczulska A. - Jagiellonian University Medical College, Cracow, Poland Murer L. - AOP-University of Padova, Italy Obukhova V. - Research Institute of Pediatrics and Children Surgery, Moscow, Russia Oh J. - University Medical Center Hamburg-Eppendorf, Hamburg, Germany Ortega P. - Hospital Universitari La Fe, Valencia, Spain Özçakar Z.B. - Ankara University School of Medicine, Ankara, Turkey. Ulinski T. - Armand-Trousseau Hospital, Paris, France Pasini A. - Azienda Ospedaliero Universitaria, Policlinico Sant’Orsola-Malpighi, Bologna, Italy. Papalia T. - Azienda Ospedaliera, Italy, Cosenza Paunova S. - Pirogov Russian National Research Medical University, Moscow, Russia Pena A. - Hospital Infantil La Paz, Madrid, Spain. Pecoraro C. - Children Hospital Santobono-Pausilipon, Naples Italy Petrosyan E. - Russian National Research Medical University, Moscow, Russia Peruzzi L. - Regina Margherita Children’s Hospital, Città della Salute e della Scienza di Torino, Turin, Italy Printza N. - Hippokration General Hospital, Aristotle University, Thessaloniki, Greece. Prikhodina L. - Pirogov Russian National Research Medical University, Moscow, Russia Pietrement C. - Centre Hospitalier Universitaire de Reims, France Rittig S. - Aarhus University Hospital, Aarhus, Denmark Rodrigo D. - University Institute of Health Sciences Research (IUNICS-IdISPa), University of Balearic Islands, Palma de Mallorca, Spain; Savenkova N. - Saint-Petersburg State Pediatric Medical University, St Petersburg, Russia Saraga M. - School of Medicine, University of Split, Split, Croatia Sever F.L. - İstanbul University Cerrahpaşa Faculty of Medicine, İstanbul, Turkey Schreuder M. - Radboud University Medical Center, Radboud Institute for Molecular Life Sciences, Amalia Children’s Hospital, Nijmegen, The Netherlands. Szczepanska M. – Faculty of Medical Sciences in Zabrze, SUM in Katowice, Poland Tasic V. - University Children’s Hospital, Skopje, North Macedonia. Tonshoff B. - University Children’s Hospital Heidelberg, Heidelberg, Germany. Tullus K. - Great Ormond Street NHS Foundation Trust Hospital, London, UK. Vara J. - Martin Hospital Universitario 12 de Octubre, Madrid, Spain Vande Walle J. - Safepedrug, University Hospital Gent, Gent, Belgium Volokhina E. - Amalia Children’s Hospital Radboud University Medical Center Nijmegen, The Netherlands. Zieg J. - Second Medical Faculty, Motol University Hospital, Charles University, Prague, Czech Republic. Waters A. - Great North Children’s Hospital, Newcastle Upon Tyne, UK. Weber L.T. - University Hospital of Cologne, Cologne, Germany Webbe N. - University of Manchester, Manchester Academic Health Science Centre, Royal Manchester Children’s Hospital, Manchester, UK Wasiak M. - Department of Pediatrics and Nephrology, Medical University of Warsaw, Warsaw, Poland. Funding Information: This study was supported by ESPN—European Society Pediatric Nephrology. No other funding was received. Publisher Copyright: © 2023, The Author(s).
PY - 2023/9
Y1 - 2023/9
N2 - Background: There is paucity of information on rituximab-associated hypogammaglobulinemia (HGG) and its potential infectious consequences in children treated for idiopathic nephrotic syndrome (INS). Methods: A survey was distributed by the European Society Pediatric Nephrology to its members. It addressed the screening and management practices of pediatric nephrology units for recognizing and treating RTX-associated HGG and its morbidity and mortality. Eighty-four centers which had treated an overall 1328 INS children with RTX responded. Results: The majority of centers administered several courses of RTX and continued concomitant immunosuppressive therapy. Sixty-five percent of centers routinely screened children for HGG prior to RTX infusion, 59% during, and 52% following RTX treatment. Forty-seven percent had observed HGG prior to RTX administration, 61% during and 47% >9 months following treatment in 121, 210, and 128 subjects respectively. Thirty-three severe infections were reported among the cohort of 1328 RTX-treated subjects, of whom 3 children died. HGG had been recognized in 30/33 (80%) of them. Conclusions: HGG in steroid-dependent/frequently relapsing nephrotic syndrome (SDNS/FRNS) children is probably multifactorial and can be observed prior to RTX administration in children with SDNS/FRNS. Persistent HGG lasting >9 months from RTX infusion is not uncommon and may increase the risk of severe infections in this cohort. We advocate for the obligatory screening for HGG in children with SDNS/FRNS prior to, during, and following RTX treatment. Further research is necessary to identify risk factors for developing both HGG and severe infections before recommendations are made for its optimal management. Graphical abstract: [Figure not available: see fulltext.]
AB - Background: There is paucity of information on rituximab-associated hypogammaglobulinemia (HGG) and its potential infectious consequences in children treated for idiopathic nephrotic syndrome (INS). Methods: A survey was distributed by the European Society Pediatric Nephrology to its members. It addressed the screening and management practices of pediatric nephrology units for recognizing and treating RTX-associated HGG and its morbidity and mortality. Eighty-four centers which had treated an overall 1328 INS children with RTX responded. Results: The majority of centers administered several courses of RTX and continued concomitant immunosuppressive therapy. Sixty-five percent of centers routinely screened children for HGG prior to RTX infusion, 59% during, and 52% following RTX treatment. Forty-seven percent had observed HGG prior to RTX administration, 61% during and 47% >9 months following treatment in 121, 210, and 128 subjects respectively. Thirty-three severe infections were reported among the cohort of 1328 RTX-treated subjects, of whom 3 children died. HGG had been recognized in 30/33 (80%) of them. Conclusions: HGG in steroid-dependent/frequently relapsing nephrotic syndrome (SDNS/FRNS) children is probably multifactorial and can be observed prior to RTX administration in children with SDNS/FRNS. Persistent HGG lasting >9 months from RTX infusion is not uncommon and may increase the risk of severe infections in this cohort. We advocate for the obligatory screening for HGG in children with SDNS/FRNS prior to, during, and following RTX treatment. Further research is necessary to identify risk factors for developing both HGG and severe infections before recommendations are made for its optimal management. Graphical abstract: [Figure not available: see fulltext.]
KW - Children
KW - Hypogammaglobulinemia
KW - Nephrotic syndrome
KW - Rituximab
UR - http://www.scopus.com/inward/record.url?scp=85151759981&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85151759981&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/37014530
U2 - https://doi.org/10.1007/s00467-023-05913-1
DO - https://doi.org/10.1007/s00467-023-05913-1
M3 - Article
C2 - 37014530
SN - 0931-041X
VL - 38
SP - 3035
EP - 3042
JO - Pediatric nephrology (Berlin, Germany)
JF - Pediatric nephrology (Berlin, Germany)
IS - 9
ER -