Ouanjine Arij, Fendri Fatma, Miquelestorena-Standley Elodie, Kerdraon Remy, Dekeyser Manon
Department of Nephrology, Centre Hospitalier Universitaire d'Orléans, Orleans, FRA.
Department of Pathology, Centre Hospitalier Universitaire de Tours, Tours, FRA.
Cureus. 2025 Jun 12;17(6):e85841. doi: 10.7759/cureus.85841. eCollection 2025 Jun.
A 63-year-old man, with no relevant history, developed acute kidney injury with an elevated serum creatinine level of 314 µmol/L associated with hypertension, a nephrotic syndrome, without hematuria. Kidney biopsy revealed a glomerular-specific deposition of DnaJ homolog subfamily B member 9 (DNAJB9). Fibrillary glomerulonephritis was diagnosed. The patient received corticosteroids, rituximab (1 g at day 1 and day 15; 1 g at month 6), and nephroprotection. Kidney dysfunction initially worsened (creatinine 513 µmol/L), and peritoneal dialysis was initiated. Partial renal function recovery was observed after the rituximab-maintenance dose, allowing dialysis discontinuation for one year (October 2023 to September 2024). In some studies, rituximab-based therapy was associated with stabilization of disease progression. As observed in our case, it could be considered on a case-by-case basis, with a possible benefit for partial treatment response and time-limited disease control.
一名63岁男性，无相关病史，出现急性肾损伤，血清肌酐水平升高至314µmol/L，伴有高血压、肾病综合征，无血尿。肾活检显示DnaJ同源亚家族B成员9（DNAJB9）的肾小球特异性沉积。诊断为纤维样肾小球肾炎。患者接受了皮质类固醇、利妥昔单抗（第1天和第15天各1g；第6个月1g）以及肾脏保护治疗。肾功能最初恶化（肌酐513µmol/L），并开始进行腹膜透析。在利妥昔单抗维持剂量治疗后观察到部分肾功能恢复，使得透析中断了一年（2023年10月至2024年9月）。在一些研究中，基于利妥昔单抗的治疗与疾病进展稳定相关。如我们病例中所见，可根据具体情况考虑使用，可能对部分治疗反应和限时疾病控制有益。
