Membranous nephropathy associated with immunoglobulin G4-related disease successfully treated with obinutuzumab

Clin Kidney J. 2021 Dec 8;15(3):564-566. doi: 10.1093/ckj/sfab250. eCollection 2022 Mar.

Abstract

Immunoglobulin G4 (IgG4)-releated disease is typically associated with interstitial nephritis, but rare cases of idiopathic membranous nephropathy as a renal manifestation have been described. Obinutuzumab was successfully used in refractory membranous nephropathy, but evidence for the treatment of IgG4-related disease with obinutuzumab is lacking. We report one patient's case with membranous nephropathy associated with IgG4-related disease who was treated with obinutuzumab following an anaphylactic reaction to rituximab. Obinutuzumab treatment resulted in a sustained complete remission of membranous nephropathy and a decrease of IgG4 to the normal range. This case demonstrates that membranous nephropathy associated with IgG4-related disease can be treated successfully with obinutuzumab.

Keywords: B lymphocytes; IgG4-related disease; kidney disease; membranous nephropathy.