Successful rituximab treatment of recurrent glomerulonephritis associated with antibodies against the glomerular basement membrane

This article presents a case of recurrent anti-GBM disease (with antibodies against the glomerular basement membrane [GBM]) in a 17-year-old patient successfully treated with rituximab. Kidney biopsy with detection of linear deposition of immunoglobulin G (IgG) along the basement membrane is the dia...

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Bibliographic Details
Published in:Der Internist (Berlin) 2020-04, Vol.61 (4), p.416
Main Authors: Chittka, D, Lennartz, L, Jung, B, Banas, B, Bergler, T
Format: Article
Language:ger
Subjects:
Adolescent
Anti-Glomerular Basement Membrane Disease - drug therapy
Anti-Glomerular Basement Membrane Disease - immunology
Anti-Glomerular Basement Membrane Disease - pathology
Antibodies, Monoclonal
Autoantibodies
Biopsy
Glomerular Basement Membrane - pathology
Glomerulonephritis - diagnosis
Glomerulonephritis - drug therapy
Humans
Immunoglobulin G - immunology
Immunologic Factors - therapeutic use
Kidney - pathology
Plasma Exchange
Proteinuria
Recurrence
Rituximab - therapeutic use
Treatment Outcome
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Summary:This article presents a case of recurrent anti-GBM disease (with antibodies against the glomerular basement membrane [GBM]) in a 17-year-old patient successfully treated with rituximab. Kidney biopsy with detection of linear deposition of immunoglobulin G (IgG) along the basement membrane is the diagnostic gold standard, which should be accompanied by serological testing. However, standard assays for the detection of anti-GBM antibodies have a high rate of false-negative results. In this particular case, an increase in proteinuria despite standard therapy (plasmapheresis, steroids, cyclophosphamide) was the clinical correlate of relapsing disease. The use of rituximab completely resolved the recurrent anti-GBM disease.
ISSN:1432-1289
DOI:10.1007/s00108-020-00773-5