title: Successful treatment of recurrent focal segmental glomerulosclerosis with a low dose rituximab in a kidney transplant recipient.
abstract: Recurrence of focal segmental glomerulosclerosis (FSGS) is a major therapeutic challenge in kidney transplantation (KT). Although intensive plasmapheresis and high-dose rituximab have been introduced to treat recurrent FSGS, the most effective dosage and regimen of rituximab have not been determined. Herein we reported the first case of successful treatment of recurrent FSGS with a low-dose rituximab. The patient showed marked proteinuria (3.5 g/d) and oliguria 2 d after KT. Two courses of plasmapheresis and immunoglobulin were applied to the patient, however, nephrotic range proteinuria persisted and creatinine level increased to 3.56 mg/dL. Five months post-transplant, the patient received injection with only one dose of rituximab 100 mg, without further plasmapheresis, which resulted in immediate reduction of serum creatinine and full remission of proteinuria during the following 18 months. This case suggested that recurrent FSGS, which frequently relapses after plasmapheresis, could be treated successfully with a low-dose rituximab even without plasmapheresis.
authors: Department of Internal Medicine, Kyungpook National University School of Medicine , Daegu , Korea .
authors: Jang-Hee
authors: JH
authors: Cho
authors: Jong-Hak
authors: JH
authors: Lee
authors: Ga-Young
authors: GY
authors: Park
authors: Jeong-Hoon
authors: JH
authors: Lim
authors: Jun-Seop
authors: JS
authors: Kim
authors: Yoon-Jung
authors: YJ
authors: Kang
authors: Owen
authors: O
authors: Kwon
authors: Ji-Young
authors: JY
authors: Choi
authors: Sun-Hee
authors: SH
authors: Park
authors: Yong-Lim
authors: YL
authors: Kim
authors: Hyung-Kee
authors: HK
authors: Kim
authors: Seung
authors: S
authors: Huh
authors: Chan-Duck
authors: CD
authors: Kim
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage*; D003404:Creatinine / Q000097:blood; D005923:Glomerulosclerosis, Focal Segmental / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage*; D016030:Kidney Transplantation; D008297:Male; D010956:Plasmapheresis; D011507:Proteinuria; D012008:Recurrence; D000069283:Rituximab; D066027:Transplant Recipients
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab; D003404:Creatinine