Successful treatment of recurrent focal segmental glomerulosclerosis with a low dose rituximab in a kidney transplant recipient

被引：18

作者：

Cho, Jang-Hee ^{[1
,2
]}

Lee, Jong-Hak ^{[1
,2
]}

Park, Ga-Young ^{[1
,2
]}

Lim, Jeong-Hoon ^{[1
,2
]}

Kim, Jun-Seop ^{[1
,2
]}

Kang, Yoon-Jung ^{[1
,2
]}

Kwon, Owen ^{[1
,2
]}

Choi, Ji-Young ^{[1
,2
]}

Park, Sun-Hee ^{[1
,2
]}

Kim, Yong-Lim ^{[1
,2
]}

Kim, Hyung-Kee ^{[3
]}

Huh, Seung ^{[3
]}

Kim, Chan-Duck ^{[1
,2
]}

机构：

[1] Kyungpook Natl Univ, Sch Med, Dept Internal Med, Taegu 700721, South Korea

[2] Clin Res Ctr End Stage Renal Dis, Taegu, South Korea

[3] Kyungpook Natl Univ, Sch Med, Dept Surg, Taegu 700721, South Korea

来源：

RENAL FAILURE | 2014年 / 36卷 / 04期

关键词：

Focal segmental glomerulosclerosis; kidney transplantation; plasmapheresis; relapse; rituximab; RENAL-TRANSPLANTATION; NEPHROTIC SYNDROME; THERAPY; RESOLUTION;

D O I：

10.3109/0886022X.2014.882238

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Recurrence of focal segmental glomerulosclerosis (FSGS) is a major therapeutic challenge in kidney transplantation (KT). Although intensive plasmapheresis and high-dose rituximab have been introduced to treat recurrent FSGS, the most effective dosage and regimen of rituximab have not been determined. Herein we reported the first case of successful treatment of recurrent FSGS with a low-dose rituximab. The patient showed marked proteinuria (3.5 g/d) and oliguria 2 d after KT. Two courses of plasmapheresis and immunoglobulin were applied to the patient, however, nephrotic range proteinuria persisted and creatinine level increased to 3.56 mg/dL. Five months post-transplant, the patient received injection with only one dose of rituximab 100 mg, without further plasmapheresis, which resulted in immediate reduction of serum creatinine and full remission of proteinuria during the following 18 months. This case suggested that recurrent FSGS, which frequently relapses after plasmapheresis, could be treated successfully with a low-dose rituximab even without plasmapheresis.

引用

页码：623 / 626

页数：4

共 21 条

[1] Rituximab therapy prevents focal and segmental glomerulosclerosis recurrence after a second renal transplantation [J].