Rituximab-induced persistent hypogammaglobulinemia in children with nephrotic syndrome: common or rare?

In recent years, B-cell targeted therapies (BCTT), especially rituximab (RTX), have become an integral part of management in difficult-to-treat pediatric nephrotic syndrome (NS). They serve as a third-line therapeutic option for both steroid-dependent/frequently relapsing (SD/FR) NS as well as steroid-resistant (SR) NS patients ([1], [2]). With its wide adoption as a treatment option for childhood NS, practitioners have described a growing list of adverse effects. In this editorial, we aim to highlight the risk of transient hypogammaglobulinemia (HGG) and persistent hypogammaglobulinemia (PHGG) post-BCTT in children with NS.