What question did this study set out to answer?

To assess the effects of dupilumab in a nephrotic syndrome patient undergoing rituximab maintenance therapy.

June 1, 2026Open Access

Experience with Dupilumab in Patient with Nephrotic Syndrome Receiving Rituximab Maintenance Therapy

ASAya SaitoJikei University School of Medicine DHDaishi HiranoJikei University School of Medicine YHYuna HiwatariJikei University School of Medicine

Puntos clave

To assess the effects of dupilumab in a nephrotic syndrome patient undergoing rituximab maintenance therapy.
Patient case report of a 22-year-old male with nephrotic syndrome and atopic dermatitis.
Initiation of dupilumab therapy after failure of topical treatments and cyclosporine.
Monitoring of eczema severity and serum biomarkers over 10 months.
Significant improvement in atopic dermatitis with IGA score reduced to 1 and EASI score to 1.5 after 10 months of treatment.
Serum IgE levels decreased to 70 IU/mL and TARC levels to 74 pg/mL.
No serious adverse events were reported, and nephrotic syndrome remained in remission for 3 years and 6 months.

Resumen

症例は22歳男性．12歳時に特発性ネフローゼ症候群（nephrotic syndrome: NS）を発症し，ステロイド抵抗性のため複数の免疫抑制療法を要した．現在はリツキシマブ（rituximab: RTX）6か月毎投与とミコフェノール酸モフェチルにより寛解維持中である．一方で，中等症アトピー性皮膚炎（atopic dermatitis: AD）を合併し，Investigator’s Global assessment（IGA）3，Eczema Area and Severity Index （EASI）20.45と難治性で外用療法やシクロスポリンで十分な改善が得られなかった．掻痒による集中力低下と睡眠障害が学業に支障をきたし，22歳時にデュピルマブ（dupilumab: DUPI）を導入した．治療開始10か月後，IGA 1，EASI 1.5へ著明に改善し，血清IgEは70 IU/mLに，thymus and activation-regulated chemokine（TARC）は74 pg/mLまで低下した．結膜炎以外の副作用は認めず，NSも3年6か月再燃していない．RTX維持療法中のNS患者へDUPI使用の初めての報告であり，RTX使用下にDUPIを重篤な有害事象なく安全に併用し，ADの良好なコントロールを得ることができた．

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