PDF(Pubmed)
Abstract：
UNASSIGNED: Minimal change disease (MCD) is a common cause of adult nephrotic syndrome. Most adults with MCD achieve 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.
UNASSIGNED: 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.
UNASSIGNED: This case demonstrates the successful treatment of frequently relapsed, steroid-dependent, and rituximab-resistant MCD with obinutuzumab. Obinutuzumab is a promising therapeutic option for rituximab-resistant MCD.
UNASSIGNED: 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.
UNASSIGNED: This case demonstrates the successful treatment of frequently relapsed, steroid-dependent, and rituximab-resistant MCD with obinutuzumab. Obinutuzumab is a promising therapeutic option for rituximab-resistant MCD.
摘要：
■微小病变（MCD）是成人肾病综合征的常见原因。大多数患有MCD的成年人在初始类固醇治疗后达到完全缓解(CR)。然而,大约30%的对类固醇有反应的成年人经常复发，成为类固醇依赖性和潜在发展难治性MCD。在成人中治疗难治性MCD提出了重大挑战。
■一位37岁的女性出现在肾脏病科，有6年的MCD病史。通过肾活检证实了MCD的诊断。她最初通过类固醇治疗获得CR，但在类固醇逐渐减少期间经历了复发。尽管发生了多次复发，但使用类固醇和他克莫司的方案实现了随后的CR。利妥昔单抗导致另一个CR，但它的维护只持续了6个月。对随后的利妥昔单抗治疗的反应不令人满意。最终,选择了obinutuzumab，导致CR的诱导和维持12个月。
■此病例证明了对频繁复发的成功治疗，类固醇依赖性，和利妥昔单抗耐药的MCD与奥比妥珠单抗。奥比妥珠单抗是利妥昔单抗耐药MCD的一种有前途的治疗选择。
■一位37岁的女性出现在肾脏病科，有6年的MCD病史。通过肾活检证实了MCD的诊断。她最初通过类固醇治疗获得CR，但在类固醇逐渐减少期间经历了复发。尽管发生了多次复发，但使用类固醇和他克莫司的方案实现了随后的CR。利妥昔单抗导致另一个CR，但它的维护只持续了6个月。对随后的利妥昔单抗治疗的反应不令人满意。最终,选择了obinutuzumab，导致CR的诱导和维持12个月。
■此病例证明了对频繁复发的成功治疗，类固醇依赖性，和利妥昔单抗耐药的MCD与奥比妥珠单抗。奥比妥珠单抗是利妥昔单抗耐药MCD的一种有前途的治疗选择。
