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CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1561638
Obinutuzumab for Treatment of Membranous Nephropathy in Patients Positive and Negative for the Phospholipase A2 Receptor Antibody: Case Reports
Provisionally accepted- 1 Shandong First Medical University Affiliated People's Hospital, Jinan, China
- 2 Nanfang Hospital, Southern Medical University, Guangzhou, China
Membranous nephropathy (MN) is a common cause of nephrotic syndrome (NS) in adults. Without treatment, two-thirds of patients with MN develop non-progressive chronic kidney disease or end-stage renal disease within 10 years. Obinutuzumab, which binds to CD20 and leads to a pronounced depletion of B cells, may elicit a better therapeutic response in patients with refractory MN who do not respond to rituximab or who have recurrent episodes. We describe two MN patients, one positive and one negative for the M-type phospholipase A2 receptor antibody (PLA2R Ab).Both patients had poor responses to rituximab, but had different responses to obinutuzumab. The patient positive for PLA2R Ab had an immunologic response, and the patient negative for PLA2R Ab had a near-complete clinical response. The efficacy of obinutuzumab for treatment of refractory MN needs to be verified by large-scale multicenter clinical trials.
Keywords: Membranous nephropathy, PLA2R, Obinutuzumab, rituximab, Nephrotic Syndrome
Received: 16 Jan 2025; Accepted: 28 Mar 2025.
Copyright: © 2025 王 and WU. 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:
Huiyi WU, Nanfang Hospital, Southern Medical University, Guangzhou, China
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