| Rituximab and Plasmapheresis for Post-transplant Recurrence of FSGS |
| Ju-Yeon Nam, M.D.1, An-Sook Choi, M.D.1, Su-Jin Kim, M.D.1, Byoung-Hoon Ji, M.D.1, Joon-Suk Oh, M.D.1, Young-Ki Son, M.D.1, Yong-Hun Sin, M.D.1, Joong-Kyung Kim, M.D.1 and Yong-Jin Kim, M.D.2 |
Division of Nephrology, Department of Internal Medicine Bong Seng Memorial Hospital, Busan, Korea1
Department of Pathology, Yeung Nam University Hospital2 |
| 증례 : 신장 이식 후 재발한 국소성 분절성 사구체 경화증 치료로 사용한 Rituximab과 혈장교환술 plasmapheresis 1예 |
| 남주연1, 최안숙1, 김수진1, 지병훈1, 오준석1, 손영기1, 신용훈1, 김중경1, 김용진2 |
| 김원묵 기념 봉생병원 내과학교실1 , 영남대학교 병리학교실2 |
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| Abstract |
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Focal segmental glomerular sclerosis (FSGS) is known to recur in 20-40% of the renal allografts with graft loss in about half of these cases. We report a successful treatment of a recurrent FSGS after kidney transplantation with rituximab and plasmapheresis. An 16-year-old patient whose primary kidney disease was FSGS developed recurrence of proteinuria after living donor kidney transplantation despite preemptive plasmapheresis and one dose of rituximab (375 mg/m2). After kidney transplantation, nephritic range proteinuria was detected. Kidney biopsy was done and showed recurrent FSGS. She undergone 11 times of plasmapheresis in the first 4 week post transplantation. In addition, she received additional one dose of rituximab (375 mg/m2) on day 14. Proteinuria was decreased below nephritic range at 37 day. Ten months later, proteinuria was at 30 mg/day with excellent graft function. No significant adverse events related to rituximab or plasmapheresis were observed. Rituximab with plasmapheresis may be another option for recurrent FSGS after kidney transplantation. |
| Key Words:
Focal segmental glomerulosclerosis, Rituximab, Kidney transplantation |
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