{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:49:55Z","timestamp":1776905395503,"version":"3.51.2"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Minimal change nephrotic syndrome (MCNS) has traditionally been linked to T\u2010cell dysfunction; however, mounting evidence suggests that B\u2010cell\u2010mediated mechanisms also play a significant role. Rituximab (RTX) is increasingly utilized as maintenance therapy for recurring MCNS, yet its extended safety profile remains uncertain. In this study, we report a rare case of MCNS complicated by classical Hodgkin lymphoma (cHL) that emerged during prolonged RTX maintenance therapy. A 23\u2010year\u2010old woman with relapsing MCNS achieved sustained remission with RTX maintenance therapy. Following 13 RTX courses, the patient developed nodular sclerosis\u2013type cHL and attained complete remission with A\u2009+\u2009AVD chemotherapy (adriamycin, brentuximab vedotin, vinblastine, and dacarbazine). Despite successful chemotherapy for cHL, the patient relapsed with nephrotic syndrome featuring significant proteinuria (8.43\u2009g\/day) as RTX efficacy declined. This clinical progression illustrates a close temporal link between RTX effect loss and disease recurrence, supporting the contributory role of elevated peripheral CD19+ B cells in MCNS relapse. Although sustained B\u2010cell\u2013targeted therapy seems effective for prolonged disease management, the exceedingly rare incidence of cHL during extended RTX maintenance in this patient highlights the importance of vigilant long\u2010term safety monitoring with prolonged B\u2010cell depletion.<\/jats:p>","DOI":"10.1111\/nep.70205","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:40:06Z","timestamp":1776314406000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Minimal Change Nephrotic Syndrome Complicated by Classical Hodgkin Lymphoma During Prolonged Rituximab Maintenance Therapy: A Case Report"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2282-1322","authenticated-orcid":false,"given":"Koshi","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Nephrology Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0918-4203","authenticated-orcid":false,"given":"Mayu","family":"Kijiya","sequence":"additional","affiliation":[{"name":"Department of Nephrology Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0152-3443","authenticated-orcid":false,"given":"Takeo","family":"Koshida","sequence":"additional","affiliation":[{"name":"Department of Nephrology Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0513-4433","authenticated-orcid":false,"given":"Tomohito","family":"Gohda","sequence":"additional","affiliation":[{"name":"Department of Nephrology Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4077-9747","authenticated-orcid":false,"given":"Yusuke","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Nephrology Juntendo University Faculty of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.761600"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2021060794"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nep.12737"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3002231"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-11-251132"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.66.4482"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21186623"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/bcj.2017.85"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1002965"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70205","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.70205","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.70205","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:07:49Z","timestamp":1776902869000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.70205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/nep.70205"],"URL":"https:\/\/doi.org\/10.1111\/nep.70205","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2026-02-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70205"}}