Gee Caroline, Le Dao, Nguyen Matthew D, Sisk Anthony, Hanna Ramy
Division of Nephrology, Hypertension and Kidney Transplantation, University of California, Irvine, CA, USA.
Division of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA.
SAGE Open Med Case Rep. 2025 May 13;13:2050313X251333979. doi: 10.1177/2050313X251333979. eCollection 2025.
Non-lupus full-house nephropathy describes a pattern of "full-house" immunofluorescence on renal biopsy in the absence of clinical or serologic markers for systemic lupus erythematosus. It is a rare disease with a broad range of etiologies, including idiopathic, secondary, or a prodrome of systemic lupus erythematosus. Current treatment options are lacking, with mixed results in the literature for varied immunosuppressive regimens. Rituximab, a selective anti-CD20 B-cell monoclonal antibody, has shown success in immune-complex mediated glomerular diseases but has not been commonly used or studied in non-lupus full-house nephropathy. Here, we present a case of non-lupus full-house nephropathy that was refractory to first-line immunosuppressants, in which two rounds of rituximab treatment achieved a positive response. This case emphasizes the need for systemic analysis of rituximab use in non-lupus full-house nephropathy, particularly given its mixed etiologies and presentations.
非狼疮性满堂亮肾病是指在肾活检时呈现“满堂亮”免疫荧光模式，但缺乏系统性红斑狼疮的临床或血清学标志物。它是一种罕见疾病，病因广泛，包括特发性、继发性或系统性红斑狼疮的前驱症状。目前缺乏有效的治疗方案，文献中关于各种免疫抑制方案的结果不一。利妥昔单抗是一种选择性抗CD20 B细胞单克隆抗体，已在免疫复合物介导的肾小球疾病中显示出疗效，但在非狼疮性满堂亮肾病中尚未得到广泛应用或研究。在此，我们报告一例一线免疫抑制剂治疗无效的非狼疮性满堂亮肾病病例，经两轮利妥昔单抗治疗后取得了阳性反应。该病例强调了对利妥昔单抗在非狼疮性满堂亮肾病中的应用进行系统分析的必要性，尤其是考虑到其病因和表现的多样性。
