Rituximab Treatment for Adult Purpura Nephritis with Nephrotic Syndrome

Hiroaki Ishiguro; Tatsuo Hashimoto; Mariko Akata; Shota Suzuki; Kengo Azushima; Yusuke Kobayashi; Tomohiko Kanaoka; Shinichiro Yoshida; Hiromichi Wakui; Jin Oshikawa; Kiyotaka Nagahama; Yoshiaki Inayama; Kouichi Tamura; Yoshiyuki Toya; Satoshi Umemura

doi:10.2169/internalmedicine.52.9325

CASE REPORTS

Rituximab Treatment for Adult Purpura Nephritis with Nephrotic Syndrome

Hiroaki Ishiguro, Tatsuo Hashimoto, Mariko Akata, Shota Suzuki, Kengo Azushima, Yusuke Kobayashi, Tomohiko Kanaoka, Shinichiro Yoshida, Hiromichi Wakui, Jin Oshikawa, Kiyotaka Nagahama, Yoshiaki Inayama, Kouichi Tamura, Yoshiyuki Toya, Satoshi Umemura

Author information

Hiroaki Ishiguro
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Tatsuo Hashimoto
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Mariko Akata
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Shota Suzuki
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Kengo Azushima
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Yusuke Kobayashi
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Tomohiko Kanaoka
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Shinichiro Yoshida
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Hiromichi Wakui
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Jin Oshikawa
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Kiyotaka Nagahama
Department of Pathology, Yokohama City University School of Medicine, Japan
Yoshiaki Inayama
Department of Pathology, Yokohama City University School of Medicine, Japan
Kouichi Tamura
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Yoshiyuki Toya
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan
Satoshi Umemura
Department of Medical Science and Cardiorenal Medicine, Yokohama City University School of Medicine, Japan

Keywords: purpura nephritis, nephrotic syndrome, corticosteroids, cyclophosphamide, rituximab

JOURNAL OPEN ACCESS

2013 Volume 52 Issue 10 Pages 1079-1083

DOI https://doi.org/10.2169/internalmedicine.52.9325

Details

Abstract

The case of a 68-year-old woman with purpura nephritis associated with nephrotic syndrome is herein described. The patient's clinical course and the findings of a renal biopsy study revealed purpura nephritis. Following treatment with corticosteroids and intravenous cyclophosphamide accompanied by an angiotensin II type I receptor-blocker, an anti-platelet drug and an hydroxymethylglutaryl (HMG)-CoA, the proteinuria mildly decreased. Additional rituximab therapy led to a complete remission. This report describes our successful experience using rituximab to treat refractory nephrotic syndrome of purpura nephritis. Further studies are required to confirm the efficacy of rituximab as an alternative therapy for nephrotic syndrome.

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