08 May 2026
: Case report 
Reversible Rituximab-Induced Bronchiectasis: A Pediatric Case Report and Literature Review
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Adverse events of drug therapy, Educational Purpose (only if useful for a systematic review or synthesis)
Nasser AlHarbi AD 1*, Ahmed AlEidan
E 2, Masheal A. AlZanbagi BF 2
DOI: 10.12659/AJCR.952043
Am J Case Rep 2026; 27:e952043
Table 1 Case summary and timeline.
| Timeframe | Clinical status and diagnostic findings | Interventions | Outcomes |
|---|---|---|---|
| Age 6 years | Diagnosis of minimal change disease nephrotic syndrome | Initial prednisolone (60 mg QD) | Frequent relapses, steroid dependency |
| Age 6–10 | Persistent relapses despite therapy | Trials of cyclosporin and tacrolimus | Failed maintenance, continued relapses |
| Age 10 | Introduction of rituximab (5 doses) | Rituximab started; baseline IVIG for hypogammaglobulinemia | Complete remission of MCD; B-cell suppression (low CD19) |
| Age 11 | Development of chronic productive cough (yellow-green sputum). CXR: Mild hilar infiltrates | Antibiotics for presumed pneumonia | Recurrent symptoms; multiple hospital admissions |
| Age 11.5 | Persistent symptoms; Crackles/reduced breath sounds. HRCT: Segmental atelectasis, bronchiectasis, mucus plugging | Viral multiplex (Adenovirus/Rhinovirus); Sputum culture (MDR ) | Diagnosis: chronic suppurative lung disease |
| Age 12 | Persistent hypogammaglobulinemia and B-cell suppression | Discontinuation of Rituximab. Started azithromycin (3×weekly). Airway clearance therapy | Initiation of long-term pulmonary rehabilitation |
| Age 12–16 | Gradual B-cell recovery; Persistent low IgA/IgM/IgG | Total of 8 cycles of IVIG. Ongoing pulmonary support | Clinical stabilization, asymptomatic status |
| Age 16 (follow-up) | Normal Pulmonary Function Tests (PFTs). Follow-up HRCT. Full resolution of bronchiectasis | Maintenance of remission without further rituximab | Complete radiological and clinical recovery |