Plasma exchange and rituximab treatments in primary membranous nephropathy combined with crescentic glomerulonephritis A case report
Plasma exchange and rituximab treatments in primary membranous nephropathy combined with crescentic glomerulonephritis A case report
复制标题
血浆置换联合利妥昔单抗治疗原发性膜性肾病合并新月体肾小球肾炎
DOI：
10.1097/md.0000000000015303
复制
发表时间：
2019-05-01
期刊：
影响因子：
1.6
通讯作者：
Zhao, Ming-hui
中科院分区：
文献类型：
--
作者：
Lu, Hui;Cui, Zhao;Zhao, Ming-hui
Rationale: Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown.Patient concerns: A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction.Diagnoses: Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level.Interventions: The patient received plasma exchange and rituximab besides corticosteroids.Outcomes: The patient achieved complete remission of proteinuria and recovery of kidney function after the clearance of anti-PLA2R antibodies.Lesson: This case suggests a pathogenic role of anti-PLA2R antibodies in the mechanism of crescent formation in MN, which may need intensive therapy to eliminate the antibodies quickly.
