Sun Jingshu, Wu Shengqin, Yin Fang, Zhang Kunying, Wang Jianying
Clin Nephrol. 2025 Jan;103(1):63-68. doi: 10.5414/CN111228.
Rituximab (RTX) is the anti-CD20 monoclonal antibody that has been used as the first-line therapy for primary membranous nephropathy (PMN) in recent years. However, the optimal dosing regimen and timing of RTX, or combination with other immunosuppressants, especially in patients with extremely high titers (> 1,000 RU/mL) of anti-PLA2R antibody (aPLA2R), are unclear at present. This report describes the case of a 70-year-old PMN patient with extremely high aPLA2R titer who failed to respond to very high doses of RTX. We also discuss the possible reasons for treatment failure.
利妥昔单抗（RTX）是一种抗CD20单克隆抗体，近年来已被用作原发性膜性肾病（PMN）的一线治疗药物。然而，目前尚不清楚RTX的最佳给药方案和时机，以及与其他免疫抑制剂联合使用的情况，尤其是在抗磷脂酶A2受体抗体（aPLA2R）滴度极高（>1000 RU/mL）的患者中。本报告描述了一名70岁的PMN患者，其aPLA2R滴度极高，对高剂量RTX治疗无反应。我们还讨论了治疗失败的可能原因。
