Rituximab treatment of fibrillary glomerulonephritis
American journal of kidney diseases : the official journal of the National Kidney Foundation
Fibrillary glomerulonephritis belongs to a group of disorders characterized by pathogenic deposition of fibrils in glomeruli. This glomerulopathy tends to progress to end-stage kidney disease, and there currently are no treatments of proven benefit, including corticosteroids and cytotoxic agents. Because the glomerular deposits contain an immunoglobulin component, it was postulated that anti-B-cell therapy with rituximab, an anti-CD20 monoclonal antibody, may be effective in the treatment of patients with fibrillary glomerulonephritis. We describe 3 patients with fibrillary glomerulonephritis who were treated with rituximab for nephrotic-range proteinuria. Each patient also received standard antiproteinuria therapy, including blockade of the renin-angiotensin system and strict blood pressure control. All patients showed a decrease in proteinuria to less than 1.5 g/d of protein by 27 months, and kidney function was preserved throughout the duration of therapy and follow-up. No adverse effects were seen with rituximab. These outcomes suggest that treatment with rituximab may be a promising approach to the management of fibrillary glomerulonephritis, an entity previously considered refractory to therapy.
Collins, M., Navaneethan, S. D., Chung, M., Sloand, J., Goldman, B., Appel, G., & Rovin, B. H. (2008). Rituximab treatment of fibrillary glomerulonephritis. American journal of kidney diseases : the official journal of the National Kidney Foundation, 52 (6). http://dx.doi.org/10.1053/j.ajkd.2008.07.011