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Resistant and Relapsing Collapsing Glomerulopathy Successfully Treated with Rituximab-A Case Report
Nikola Zagorec1, Dragan Klarić2, Marta Klarić3
1Department of Nephrology and Dialysis, Dubrava University Hospital, School of Medicine, University of Zagreb, 10000 Zagreb, Croatia.
Collapsing glomerulopathy, a severe kidney disease, often resists treatment. Rituximab effectively induced remission in multidrug-resistant cases, even after relapse, offering new hope for patients.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- Collapsing glomerulopathy (CG) is an aggressive kidney disease often leading to end-stage renal disease.
- CG frequently shows resistance to standard immunosuppressive therapies like steroids, calcineurin inhibitors, and cyclophosphamide.
Observation:
- This report details female patients with idiopathic CG, nephrotic syndrome, and renal insufficiency resistant to multiple immunosuppressants.
- Initial treatment with rituximab (RTX) resulted in complete remission of the multidrug-resistant disease.
Findings:
- A relapse of CG with severe nephrotic syndrome and acute renal insufficiency occurred 44 months after the initial RTX administration.
- Re-administration of RTX successfully induced complete remission again, indicating sustained efficacy.
Implications:
- This case highlights RTX as a potential therapeutic option for relapsing, multidrug-resistant collapsing glomerulopathy.
- Further research and larger studies are needed to establish the definitive role of RTX in CG treatment.
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