Rituximab treatment for adult purpura nephritis with nephrotic syndrome

Intern Med. 2013;52(10):1079-83. doi: 10.2169/internalmedicine.52.9325. Epub 2013 May 15.

Abstract

The case of a 68-year-old woman with purpura nephritis associated with nephrotic syndrome is herein described. The patient's clinical course and the findings of a renal biopsy study revealed purpura nephritis. Following treatment with corticosteroids and intravenous cyclophosphamide accompanied by an angiotensin II type I receptor-blocker, an anti-platelet drug and an hydroxymethylglutaryl (HMG)-CoA, the proteinuria mildly decreased. Additional rituximab therapy led to a complete remission. This report describes our successful experience using rituximab to treat refractory nephrotic syndrome of purpura nephritis. Further studies are required to confirm the efficacy of rituximab as an alternative therapy for nephrotic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Aged
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Anticholesteremic Agents / administration & dosage
  • Anticholesteremic Agents / therapeutic use
  • Cyclophosphamide / administration & dosage
  • Cyclophosphamide / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Humans
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / etiology
  • IgA Vasculitis / complications
  • IgA Vasculitis / drug therapy*
  • Immunosuppressive Agents / therapeutic use*
  • Infusions, Intravenous
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / therapeutic use
  • Nephritis / etiology*
  • Nephritis / pathology
  • Nephrotic Syndrome / etiology*
  • Nephrotic Syndrome / pathology
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prednisolone / administration & dosage
  • Prednisolone / therapeutic use
  • Proteinuria / etiology
  • Remission Induction
  • Rituximab

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Anticholesteremic Agents
  • Immunosuppressive Agents
  • Platelet Aggregation Inhibitors
  • Rituximab
  • Cyclophosphamide
  • Prednisolone
  • Methylprednisolone