Rituximab Administered for Recurrent Membranous Nephropathy in a Kidney Transplant Recipient Did Not Eliminate Donor-Specific Antibodies
Date
2022Language
en
Keyword
Abstract
Chronic active antibody-mediated rejection is the leading cause of kidney transplant failure. Although various immunosuppressive agents have been tested, rituximab included, presently there is no effective treatment. There are reports about the beneficial role of certain immunosuppressive protocols that include rituximab to reduce donor-specific antibodies, the cause of chronic active antibody-mediated rejection. If an immunosuppressive agent reduces donor-specific antibodies, its administration before the occurrence of chronic active antibody-mediated rejection may be beneficial. We describe a case of a renal transplant recipient with recurrent membranous nephropathy and recent development of donor-specific antibodies but without histological evidence of active antibody-mediated rejection. The patient received 3 weekly doses of rituximab for recurrent membranous nephropathy, and complete remission was achieved. One year after, he has preserved an excellent renal function without proteinuria. However, repeated measurements of donor-specific antibodies revealed that rituximab only modestly reduced donor-specific antibodies. Donor-specific antibody levels remained considerably higher than the laboratory reference value. Thus, rituximab alone may not have a role to prevent chronic active antibody-mediated rejection in patients with donor-specific antibodies. © Başkent University 2022 Printed in Turkey. All Rights Reserved.
Collections
Related items
Showing items related by title, author, creator and subject.
-
Multiple viral/self immunological cross-reactivity in liver kidney microsomal antibody positive hepatitis C virus-infected patients is associated with the possession of HLA B51
Bogdanos, D. P.; Lenzi, M.; Okamoto, M.; Rigopoulou, E. I.; Muratori, P.; Ma, Y.; Muratori, L.; Tsantoulas, D.; Mieli-Vergani, G.; Bianchi, F. B.; Vergani, D. (2004)Liver Kidney Microsomal autoantibody type 1(LKM1) directed to cytochrome P4502D6 (CYP2D6) characterises autoimmune hepatitis type-2 (AIH-2), but is also found in a proportion of chronic hepatitis C virus (HCV) infected ... -
Autoimmune hepatitis type-2 and Epstein-Barr virus infection in a toddler: Art of facts or an artifact?
Zellos, A.; Spoulou, V.; Roma-Giannikou, E.; Karentzou, O.; Dalekos, G. N.; Theodoridou, M. (2013)Epstein-Barr virus (EBV) can cause frequently asymptomatic (or anicteric) and self-limited hepatitis, while occasionally may result in considerable cholestatic hepatitis. Herein, we describe the case of a previously healthy ... -
A case of membranous nephropathy associated with Sjögren syndrome, polymyositis and autoimmune hepatitis
Stefanidis, I.; Giannopoulou, M.; Liakopoulos, V.; Dovas, S.; Karasavvidou, F.; Zachou, K.; Koukoulis, G. K.; Dalekos, G. N. (2008)Sjögren syndrome (SS) is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of exocrine glands, especially lacrimal and salivary. The immunologic process which occurs in this syndrome is B cell ...