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Successful treatment of rituximab‐ and steroid‐resistant nephrotic syndrome with leukocytapheresis
Author(s) -
Takakura Maiko,
Shimizu Masaki,
Mizuta Mao,
Inoue Natsumi,
Tasaki Yuko,
Ohta Kazuhide,
Furuichi Kengo,
Wada Takashi,
Yachie Akihiro
Publication year - 2018
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21613
Subject(s) - rituximab , medicine , nephrotic syndrome , proteinuria , immunology , immune system , antibody , gastroenterology , kidney
Although rituximab (RTX) is a promising therapeutic agent for treating steroid‐resistant nephrotic syndrome (SRNS) resistant to various immunosuppressive agents, some patients have shown resistance to RTX. We report the case of a patient with RTX‐resistant nephrotic syndrome and SRNS who was successfully treated with leukocytapheresis (LCAP). After LCAP, there was a significant reduction in proteinuria and in the total number of lymphocytes, T cells, and HLA‐DR +‐ activated T cells. Moreover, the patient became sensitive to steroids and RTX. LCAP reduced circulating immune cells including activated T cells and could be effective in treating rituximab‐resistant nephrotic syndrome and SRNS and in achieving remission of proteinuria.