Resistant and Relapsing Collapsing Glomerulopathy Successfully Treated with Rituximab—A Case Report

Scientific paper - Case study

• Author: Nikola Zagorec
• Author: Dragan Klarić
• Author: Marta Klarić
• Author: Ivica Horvatić
• Author: Petar Šenjug
• Author: Matija Horaček
• Author: Jagoda Nikić
• Author: Danica Galešić Ljubanović
• Author: Krešimir Galešić
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Author's institution: University of Zagreb; School of Medicine; (Department of Pathology)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Collapsing glomerulopathy (CG) or collapsing focal segmental glomerulosclerosis (cFSGS) is an aggressive disease with a high tendency of progression to end-stage renal disease due to common resistance to conventional immunosuppressants. Rituximab (RTX), a monoclonal antibody against CD20 B cells, showed some benefit in the treatment of CG. We are reporting about female patients with an idiopathic form of CG presenting with nephrotic syndrome (NS) and renal insufficiency resistant to several immunosuppressive agents such as steroids (ST), calcineurin inhibitors (CNI), and cyclophosphamide (CYC). This multidrug-resistant disease responded to RTX with complete remission. Forty-four months after initial RTX administration, a relapse of CG with severe NS and acute renal insufficiency occurred. Repeated application of RTX led to complete remission again. To the best of our knowledge, we are reporting the first case of the relapsing multidrug-resistant form of CG, which responded to RTX. Current data about the treatment of CG with RTX is lacking and is based on rare case reports and small case series. Thus, our report can contribute to determining the role of RTX in the treatment of CG.

• Keywords (english): collapsing glomerulopathy; kidney biopsy; multidrug-resistant disease; relapsing disease; rituximab
• Language: english
• Publication type: Scientific paper - Case study
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Journal of Personalized Medicine
• Numbering: vol. 12, no. 9, 1415
• e-ISSN: 2075-4426
• DOI: https://doi.org/10.3390/jpm12091415
• URN:NBN: urn:nbn:hr:105:366035
• Publication: 2022-08-30
• Document URL: https://www.mdpi.com/2075-4426/12/9/1415
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-02-10 10:32:44