Document Detail

Rituximab therapy for Type I membranoproliferative glomerulonephritis.
MedLine Citation:
PMID:  22445472     Owner:  NLM     Status:  In-Data-Review    
Aims: Type I membranoproliferative glomerulonephritis (MPGN) is an immune-complex disease with a relatively poor prognosis. It has no established treatment in adults. Our hypothesis was that this disease would respond to B cell depletion with rituximab, an anti-CD20 monoclonal antibody. Methods: We conducted an openlabel trial, in Canada and the United States, of rituximab in 6 adult patients with Type I MPGN (4 idiopathic, 2 with cryoglobulinemia). The rituximab dose was 1,000 mg intravenously on Day 1 and on Day 15. The patients were followed for 1 year. The primary outcome was the change in proteinuria. Results: Peripheral blood B cells were suppressed, after rituximab, in all patients. The mean urinary protein excretion was 3.9 ± 2.0 g/d before treatment. Proteinuria fell in all patients, at all-time points, after rituximab administration. The difference was statistically significant (p < 0.05) at 6, 9 and 12 months, but not at 3 months. The minimum mean urinary protein excretion was 1.4 ± 1.4 g/d at 9 months. There were 2 complete and 3 partial remissions among the 6 patients. The creatinine clearance did not change significantly over the course of the study. There were no adverse effects. Conclusions: Rituximab reduced proteinuria among patients with Type I MPGN. This trial suggests that B cells may play a role in this disease and that additional study of B-cell suppression is warranted.
John J Dillon; Michelle Hladunewich; William E Haley; Heather N Reich; Daniel C Cattran; Fernando C Fervenza
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical nephrology     Volume:  77     ISSN:  0301-0430     ISO Abbreviation:  Clin. Nephrol.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0364441     Medline TA:  Clin Nephrol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  290-5     Citation Subset:  IM    
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA, Toronto Glomerulonephritis Registry, University of Toronto, Toronto, Ontario, Canada and Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Renal histology in patients with elevated serum creatinine and concurrent normal urinalysis.
Next Document:  Evaluation of T-Cell receptor diversity in pediatric patients with minimal change nephrotic syndrome...