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Rituximab for the treatment of refractory anti-glomerular basement membrane disease
Authors:Xue-Fen Yang  Xiao-Yu Jia  Xiao-Juan Yu  Zhao Cui  Ming-Hui Zhao
Abstract:
BackgroundAnti-glomerular basement membrane (anti-GBM) disease is a rare but severe autoantibody-mediated immune disorder. The typical clinical presentation includes rapidly progressive glomerulonephritis and often concurrent pulmonary hemorrhage. The present study is aimed to investigate the therapeutic effects of rituximab either used alone or with other immunosuppressants.MethodsEight patients diagnosed with anti-GBM disease and treated with rituximab from 2014 to 2020 were retrospectively reviewed.ResultsEight patients included 5 males and 3 females with a median age of 58.5 years. They all presented severe kidney injuries and 1 patient had lung hemorrhage. At diagnosis, the median of serum creatinine was 246 µmol/L (ranging from 91 to 850 µmol/L), with 3 patients requiring dialysis. All of them received corticosteroids and plasmapheresis. Rituximab was given as either standard four weekly doses or one pulse ranging from 100 to 600 mg. After a median follow-up of 34.5 months, kidney function was partially recovered or stabilized in 5/8 (62.5%) patients, free of dialysis. Anti-GBM antibodies remained undetected in all patients during follow-up. No severe adverse effect associated with rituximab was observed.ConclusionRituximab may be an alternative therapy in the treatment of patient with severe or refractory anti-GBM disease.
Keywords:Rituximab   anti-glomerular basement membrane disease   severe   refractory
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