Rituximab in treatment of anti-GBM antibody glomerulonephritis: A case report and literature review.

Abstract:

RATIONALE:Anti-glomerular basement membrane (GBM) disease is a T cell-mediated disease that has a poor prognosis with conventional therapy. We tested rituximab as a primary therapy to reduce anti-GBM antibody produced by B cells. PATIENT CONCERNS:A 53-year old woman with complaints of a fever, headache and abdominal discomfort showed renal failure with elevated anti-GBM antibody, and renal biopsy revealed crescentic necrotizing glomerulonephritis with linear immunoglobulin G (IgG) 1 deposition along GBM. DIAGNOSES:The patient's plasma contained autoantibodies against Goodpasture antigen, which is the NC domain of collagen IVα3, and CD4-positive helper T cells were found surrounding crescent glomeruli with the coexistence CD20-positive B cells. INTERVENTIONS:Rituximab with steroid and plasma exchange. OUTCOMES:The levels of autoantibody for Goodpasture antigen were reduced, and the patient was able to temporarily withdraw from hemodialysis. LESSONS:B cell depletion with rituximab is effective as an initial therapy for anti-GBM disease.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Uematsu-Uchida M,Ohira T,Tomita S,Satonaka H,Tojo A,Ishimitsu T

doi

10.1097/MD.0000000000017801

subject

Has Abstract

pub_date

2019-11-01 00:00:00

pages

e17801

issue

44

eissn

0025-7974

issn

1536-5964

pii

00005792-201911010-00120

journal_volume

98

pub_type

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