Anti-glomerular basement membrane diseases and thrombotic microangiopathy treated with rituximab

ABSTRACT A 68-year-old male patient presented with a 2-week history of malaise and anuria. Renal replacement therapy with haemodialysis was begun for acute kidney injury. His anti-glomerular basement membrane (anti-GBM) antibody titre was 3060 U/ml. Based on this finding, anti-GBM disease was diagno...

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Veröffentlicht in:Modern rheumatology case reports 2023-06, Vol.7 (2), p.422-425
Hauptverfasser: Honda, Nanase, Shigehara, Rihiro, Furuhashi, Kazunori, Nagai, Yoshiki, Yokogawa, Naoto
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Sprache:eng
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Zusammenfassung:ABSTRACT A 68-year-old male patient presented with a 2-week history of malaise and anuria. Renal replacement therapy with haemodialysis was begun for acute kidney injury. His anti-glomerular basement membrane (anti-GBM) antibody titre was 3060 U/ml. Based on this finding, anti-GBM disease was diagnosed. Plasmapheresis and high-dose glucocorticoid therapy were begun, but his haemolytic anaemia and thrombocytopenia progressed. A disintegrin and metalloprotease with thrombospondin type 1 motif, 13 (ADAMTS-13) activity decreased to 33%, but no inhibitor was detected. Secondary thrombotic microangiopathy was suspected, and rituximab therapy was begun. The addition of rituximab is thought to have further reduced the anti-GBM antibodies, prevented recurrence, stabilised the platelet count, and facilitated the patient’s withdrawal from plasmapheresis and glucocorticoid therapy. Rituximab may be a viable therapeutic option for anti-GBM diseases complicated with thrombotic microangiopathy.
ISSN:2472-5625
2472-5625
DOI:10.1093/mrcr/rxac091