title: Loss of a renal graft due to recurrence of anti-GBM disease despite rituximab therapy.
abstract: The recurrence of anti-glomerular basement membrane (anti-GBM) glomerulonephritis (GN) in renal transplants is very rare. We report on a patient that developed acute renal allograft dysfunction due to anti-GBM GN relapse 18 months after transplantation. As plasmaseperation, dose escalation of MMF, steroids and cyclophosphamids did not result in an improvement of the graft function, a therapy with the anti-CD20 antibody Rituximab was established in addition to plasmaseperation, cyclophosphamid and steroids. Although this resulted in a decrease of anti-GBM antibody titer, graft function deteriorated further and a renal replacement therapy had to be initiated.
authors.affiliation: Department of Nephrology, Medizinische-Poliklinik-Innenstadt, Klinikum der Universität Muenchen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Sauter
authors.forename: Holger
authors.initials: H
authors.lastname: Schmid
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Anders
authors.forename: Florian
authors.initials: F
authors.lastname: Heller
authors.forename: Max
authors.initials: M
authors.lastname: Weiss
authors.forename: Thomas
authors.initials: T
authors.lastname: Sitter
mesh_terms: D000328:Adult; D019867:Anti-Glomerular Basement Membrane Disease / Q000209:etiology*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006084:Graft Rejection / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D016030:Kidney Transplantation; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D000069283:Rituximab
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D000069283:Rituximab