Rituximab failed to improve nephrotic syndrome in renal transplant patients with recurrent focal segmental glomerulosclerosis

J. M. Yabu*, B. Ho, J. D. Scandling, F. Vincenti

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

70 Scopus citations

Abstract

Focal segmental glomerulosclerosis (FSGS) recurs in 30% of patients with FSGS receiving a first renal transplant and in over 80% of patients receiving a second transplant after a recurrence. Recurrence often leads to graft failure. The pathogenesis remains unknown and may involve a circulating permeability factor that initiates injury to the glomerular capillary. There are anecdotal reports of pediatric patients with posttransplant lymphoproliferative disorder (PTLD) and recurrent FSGS who have had remission of proteinuria after treatment with rituximab. These observations have prompted speculation that B cells may play a role in the pathogenesis of recurrent FSGS. We report four consecutive adult patients with early recurrent FSGS refractory or dependent on plasmapheresis who received rituximab (total dose 2000-4200 mg). None of the patients treated with rituximab achieved remission in proteinuria, and one patient experienced early graft loss. In these four adult renal transplant patients with recurrent FSGS, rituximab failed to diminish proteinuria.

Original languageEnglish (US)
Pages (from-to)222-227
Number of pages6
JournalAmerican Journal of Transplantation
Volume8
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Focal segmental glomerulosclerosis
  • Kindney transplantation
  • Nephrotic syndrome
  • Recurrent disease
  • Rituximab

ASJC Scopus subject areas

  • Immunology

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