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CASE REPORT article

Front. Immunol.
Sec. Vaccines and Molecular Therapeutics
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1407461
This article is part of the Research Topic Community Series in Immune Dysfunction in Nephrotic Syndrome: Volume II View all articles

Case report: Effective treatment of rituximab-resistant minimal change disease with Obinutuzumab in adult

Provisionally accepted
Qiang Wang Qiang Wang 1Lin Lin Lin Lin 2Junhui Zhen Junhui Zhen 3Bei Jiang Bei Jiang 4Guangyi Liu Guangyi Liu 4*
  • 1 Qilu Hospital of Shandong University (Qingdao), Qingdao, China
  • 2 Weifang People's Hospital, Weifang, Shandong Province, China
  • 3 Shandong University, Jinan, Shandong Province, China
  • 4 Qilu Hospital, Shandong University, Jinan, Shandong Province, China

The final, formatted version of the article will be published soon.

    Background: Minimal change disease (MCD) is a common cause of adult nephrotic syndrome. Most adults with MCD achieve a complete remission (CR) after initial steroid therapy. However, approximately 30% of adults who respond to steroids experience frequent relapses, becoming steroid dependent, and potentially developing refractory MCD. Treating refractory MCD in adults poses a significant challenge. Main body: A 37-year-old woman presented to the nephrology department with a 6-year history of MCD. The diagnosis of MCD was confirmed via renal biopsy. She initially achieved CR with steroid treatment but experienced relapse during steroid tapering. Subsequent CR was achieved with a regimen of steroids and tacrolimus although multiple relapses occurred. Rituximab led to another CR, but its maintenance lasted only 6 months. The response to subsequent rituximab treatments was unsatisfactory. Ultimately, obinutuzumab was selected, resulting in the induction and maintenance of CR for 12 months. Conclusions: This case demonstrates the successful treatment of frequently relapsed, steroid-dependent, and rituximab-resistant MCD with obinutuzumab. Obinutuzumab is as a promising therapeutic option for rituximab-resistant MCD.

    Keywords: minimal change disease, Obinutuzumab, Refractory, rituximab-resistant, Steroid-dependent

    Received: 26 Mar 2024; Accepted: 05 Jul 2024.

    Copyright: © 2024 Wang, Lin, Zhen, Jiang and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Guangyi Liu, Qilu Hospital, Shandong University, Jinan, 250012, Shandong Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.