Depletion of B Lymphocytes in Idiopathic Membranous Glomerulopathy: Results from Patients with Extended Follow-Up
| Autor: | Chrysanthi Skalioti, Costas Siamopoulos, Sophia Lionaki, John Boletis, Smaragdi Marinaki, Petros P. Sfikakis, Aliki G. Iniotaki, Lydia Nakopoulou |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
medicine.medical_specialty
Original Paper Proteinuria business.industry Complete remission Renal function B cell depletion lcsh:Diseases of the genitourinary system. Urology lcsh:RC870-923 Gastroenterology Idiopathic membranous glomerulopathy Protein excretion Endocrinology Idiopathic Membranous Glomerulopathy Nephrology Internal medicine medicine Rituximab In patient medicine.symptom business Adverse effect medicine.drug B lymphocytes |
| Zdroj: | Nephron Extra Nephron Extra, Vol 3, Iss 1, Pp 1-11 (2013) |
| ISSN: | 1664-5529 |
| Popis: | Aims: To assess the long-term therapeutic benefit of temporary depletion of B lymphocytes in patients with idiopathic membranous glomerulopathy (MGN) and search for potential predictors of response. Patients and Methods: The patients included had been diagnosed with biopsy-proven MGN in the absence of secondary causes. Estimated glomerular filtration rate should be above 30 ml/min/1.73 m2 and 24-hour proteinuria 3 g/day or more. Patients who had been treated with cyclosporine or cytotoxic agents the year prior to study entry were excluded. Depletion of B cells was achieved with rituximab, which was administered intravenously for 4 consecutive weeks. Partial remission was defined as a >50% decrease in proteinuria with absolute proteinuria 50% decrease in proteinuria and an absolute protein excretion Results: Twelve patients were studied (4 females/8 males) with a mean age of 51.3 years. No major adverse effects were observed. During a median follow-up time of 48 months, 11/12 (91.6%) patients achieved remission [7/12 (58.3%) complete remission and 4/12 (33.3%) partial remission], while 1 patient did not respond to therapy. Twelve months after therapy, 68.8% (p = 0.003) of cases had achieved partial and 28.4% complete remission. Measurements of lymphocyte subpopulations did not reveal any changes except for the B cell depletion. B cell infiltrates captured per mm3 of renal tissue in the diagnostic biopsy did not correlate with subsequent response. Conclusion: Depletion of B cells in idiopathic MGN was well tolerated and resulted in significant and long-lasting response rates in a series of 12 patients. |
| Databáze: | OpenAIRE |
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