title: Rituximab for the treatment of refractory simultaneous anti-glomerular basement membrane (anti-GBM) and membranous nephropathy.
abstract: Antibody-mediated anti-glomerular basement membrane (anti-GBM) disease occurs rarely in the presence of another B-cell disorder, membranous nephropathy. The coexistence of these two autoimmune disorders would be anticipated to require differing, specific therapies targeted to each disease process. We describe a case of concomitant membranous nephropathy and anti-GBM disease in which conventional therapy, including steroids, plasmapheresis and cyclophosphamide, failed to attenuate the anti-GBM disease, yet responded to an alternative treatment of rituximab. This B-cell directed, monoclonal, chimeric antibody treatment substantially reduced anti-GBM antibody titers and led to discontinuation of plasmapheresis, while maintaining the remission of membranous nephropathy and anti-GBM disease.
authors: Department of Internal Medicine , Henry Ford Hospital , Detroit, MI , USA.
authors: Ghassan
authors: G
authors: Bandak
authors: Department of Pathology , Henry Ford Hospital , Detroit, MI , USA.
authors: Bruce A
authors: BA
authors: Jones
authors: Division of Nephrology and Hypertension , Henry Ford Hospital , Detroit, MI , USA.
authors: Jian
authors: J
authors: Li
authors: Division of Nephrology and Hypertension , Henry Ford Hospital , Detroit, MI , USA.
authors: Jerry
authors: J
authors: Yee
authors: Division of Nephrology and Hypertension , Henry Ford Hospital , Detroit, MI , USA.
authors: Kausik
authors: K
authors: Umanath
keywords: Goodpasture syndrome; anti CD-20; anti-GBM disease; membranous nephropathy, rituximab