Seret Guillaume, Hanrotel Catherine, Bendaoud Boutahar, Le Meur Yannick, Renaudineau Yves
EA2216 Immunology and Pathology, European University of Brittany, Brest, France; Laboratory of Immunology, Brest University Medical School, CHRU Morvan,Brest, France; Unit of Nephrology, Brest University Medical School, CHRU Cavale Blanche, Brest, France.
Unit of Nephrology , Brest University Medical School, CHRU Cavale Blanche , Brest , France.
Clin Kidney J. 2013 Feb;6(1):74-76. doi: 10.1093/ckj/sfs162. Epub 2012 Dec 20.
Rituximab (RTX), an anti-CD20 monoclonal antibody, has shown promising results in a small group of systemic lupus erythematosus (SLE) patients treated for lupus nephritis (LN). However, such observations were not confirmed in the double-blind LUNAR study. Accordingly, the factors associated with the clinical response remain to be characterized. We report the case of a young woman with known LN successfully re-treated with RTX and steroids and homozygous for the low-affinity FCG3RA 158F genotype. Although B-cell depletion was delayed, complete remission with anti-DNA antibody negativity and proteinuria normalization were maintained for 5 years. The implications for disease pathogenesis and clinical monitoring are discussed.
利妥昔单抗（RTX）是一种抗CD20单克隆抗体，在一小部分接受狼疮性肾炎（LN）治疗的系统性红斑狼疮（SLE）患者中显示出了有前景的结果。然而，在双盲的LUNAR研究中并未证实这些观察结果。因此，与临床反应相关的因素仍有待明确。我们报告了一例已知患有LN的年轻女性患者，成功接受了RTX和类固醇再次治疗，且为低亲和力FCG3RA 158F基因型的纯合子。尽管B细胞耗竭延迟，但抗DNA抗体转阴和蛋白尿正常化的完全缓解状态维持了5年。文中讨论了其对疾病发病机制和临床监测的意义。
