title: Rituximab therapy for primary glomerulonephritis: Report on two cases.
abstract: The evidence in the medical literature on the efficacy and safety of rituximab therapy for primary glomerulonephritis is limited and controversial. We describe two male Caucasian patients with rapidly progressive kidney failure due to primary proliferative glomerulonephritis. Both of them received high-dose intravenous corticosteroids and oral cyclophosphamide with limited benefit. The first patient (hepatitis C virus-negative mixed cryoglobulinemia) underwent plasma-exchange with intravenous immunoglobulins; he showed significant benefit on kidney function (he became dialysis independent with serum creatinine going back to 1.6 mg/dL) after one rituximab pulse even if urinary abnormalities were still present. No improvement in renal function or urinary changes occurred in the second patient. Both these individuals developed sepsis over the follow-up, the first patient died two months after rituximab therapy. This report is in keeping with the occurrence of severe infections after rituximab therapy in patients with renal impairment at baseline and concomitant high-dose steroids.
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Fabrizio
authors: F
authors: Fabrizi
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Donata
authors: D
authors: Cresseri
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Giovanni B
authors: GB
authors: Fogazzi
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Gabriella
authors: G
authors: Moroni
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Patrizia
authors: P
authors: Passerini
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Paul
authors: P
authors: Martin
authors: Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Piergiorgio Messa, Division of Nephrology, Maggiore Hospital, IRCCS Foundation, 20122 Milano, Italy.
authors: Piergiorgio
authors: P
authors: Messa
keywords: Chronic kidney disease; Cryoglobulinemic vasculitis; Membranoproliferative glomerulonephritis; Rituximab