[采用序贯血浆滤过和利妥昔单抗治疗激素抵抗型局灶节段性肾小球硬化症]

[Steroid-resistant focal segmental glomerulosclerosis treated with cascade plasmafiltration and rituximab].

作者信息

Tatangelo Paola, Londrino Francesco, Di Vasta Giorgio, Guido Giuliana, Centi Alessia, Dominijanni Sara, Bernabei Eleonora, Caramiello Maria Stella, Di Franco Damiano, Palumbo Roberto

机构信息

U.O.C di Nefrologia e Dialisi, Ospedale S. Eugenio, Roma, Italia.

出版信息

G Ital Nefrol. 2018 May;35(3).

PMID:29786187

Abstract

A 39-year man with primary steroid resistant focal segmental glomerulosclerosis (FSGS) was treated with mycophenolate mofetil and ACE-inhibitors. After six months a different therapeutics approach was mandatory due to the worsening of renal function and the relapse of proteinuria at the nephrotic range. The combination of cascade plasmafiltration and single dose of rituximab (375 mg/m²) achieved clinical remission and improved renal function in six months follow up. Cascade plasmafiltration in association with rituximab can be considered as a salvage method for primary steroid-resistant FSGS. Clinical trials should be carried out for protocol approval.

摘要

一名39岁的原发性类固醇抵抗性局灶节段性肾小球硬化（FSGS）男性患者接受了霉酚酸酯和血管紧张素转换酶抑制剂治疗。六个月后，由于肾功能恶化和肾病范围蛋白尿复发，必须采取不同的治疗方法。级联血浆滤过和单剂量利妥昔单抗（375 mg/m²）联合使用在六个月的随访中实现了临床缓解并改善了肾功能。级联血浆滤过联合利妥昔单抗可被视为原发性类固醇抵抗性FSGS的挽救方法。应进行临床试验以获得方案批准。