Delayed Therapeutic Response to Oral Corticosteroids and Rituximab Leading to Dialysis Independence in a Patient with Treatment-resistant C3 Glomerulonephritis
A 56-year-old man with nephrotic syndrome was diagnosed with recurrent C3 glomerulonephritis (C3GN) without preceding infection. Initial treatment with steroid pulse therapy and oral glucocorticoids failed, and he required hemodialysis due to progressive kidney dysfunction. After rituximab was added, his renal function gradually improved, and dialysis was discontinued. Relapse occurred months later, but combination therapy with steroids and rituximab was effective again. The patient remained dialysis-independent with biannual rituximab infusions. This case illustrates that combining corticosteroids and rituximab may induce remission and preserve the kidney function in relapsing C3GN, even in patients requiring temporary dialysis support.
Authors
- Junko Kunieda (ORCID: https://orcid.org/0000-0001-5563-9977)
- Eisei Sohara (ORCID: https://orcid.org/0000-0003-1668-8308)
- Takayasu Mori (ORCID: https://orcid.org/0000-0002-9308-7787)
- Shotaro Naito
- Yutaro Mori (ORCID: https://orcid.org/0000-0002-8499-5636)
- Shintaro Mandai (ORCID: https://orcid.org/0000-0001-6709-306X)
- Yuki Tanaka
- Fumiaki Ando (ORCID: https://orcid.org/0000-0002-8401-1705)
- Towako Taguchi (ORCID: https://orcid.org/0009-0004-4773-8552)
- Kenichi Ohashi (ORCID: https://orcid.org/0000-0003-1836-1763)
- Soichiro Iimori
- Yuki Nakao (ORCID: https://orcid.org/0009-0008-2937-9858)
- Koichiro Susa (ORCID: https://orcid.org/0000-0002-0100-4527)
- Shin‐ichi Uchida
Institutions
- Tokyo Medical and Dental University (JP)
- Cardiovascular Institute Hospital (JP)
- JA Toride Medical Center (JP)
Publication Details
- Journal
- Internal Medicine
- Published
- 2025-01-01
- DOI
- https://doi.org/10.2169/internalmedicine.6219-25
- Primary Topic
- Renal Diseases and Glomerulopathies
- Type
- article
- Field-Weighted Citation Impact
- 0.00