Intravenous rituximab in severe refractory primary focal segmental, glomerulosclerosis
Gan Wee Leng, Ruslinda Mustafar, Lydia Kamaruzaman, Rozita Mohd, Rizna A. Cader, Kong Wei Yen, Pau Kiew Bing (University of Indonesia. Faculty of Medicine, 2018)
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ABSTRACT Managing primary or even secondary glomerulonephritis remains a challenge to many nephrologists. In primary focal segmental glomerulosclerosis (FSGS) with heavy proteinuria, renin aldosterone system blockade and high dose of oral prednisolone is the mainstay of treatment. Other immunosuppressive medications like Cyclophosphamide, Cyclosporine A and Mycophenolate Mofetil (MMF) are warranted if a complete remission is not achieved. We illustrate a case of 21 year old gentleman with primary FSGS that was difficult to achieve remission despite on high dose steroid and oral Cyclophosphamide. He was also not responsive to a combination of MMF and Cyclosporine A (CSA) and even throughout the therapy he developed significant steroid and CSA toxicity. He presented to our center with severe nephrotic syndrome and acute kidney injury requiring acute haemodialysis. Despite re-challenged him again on high dose prednisolone, total of 2.4g of intravenous Cyclophosphamide, and MMF, he failed to achieve remission. He was subsequently given intravenous Rituximab 500mg/weekly for 4 doses and able to attained remission for 1 year. He relapsed again and a second course of Rituximab 500mg/weekly for 6 doses were given to attain remission. This case demonstrates the difficulty in managing refractory steroid dependent FSGS and we found that Rituximab is proven beneficial in this case to induce remission. |
| No. Panggil : | 610 UI-IJIM 50:3 (2018) |
| Entri utama-Nama orang : | |
| Entri tambahan-Nama orang : | |
| Penerbitan : | Jakarta: University of Indonesia. Faculty of Medicine, 2018 |
| Sumber Pengatalogan : | LibUI eng rda |
| ISSN : | 01259326 |
| Majalah/Jurnal : | The Indonesian Journal of Internal Medicine |
| Volume : | Vol. 50, No. 3 July 2018: Hal. 237-243 |
| Tipe Konten : | text |
| Tipe Media : | unmediated (rda media) |
| Tipe Carrier : | volume |
| Akses Elektronik : | |
| Institusi Pemilik : | Universitas Indonesia |
| Lokasi : | Perpustakaan UI, Lantai 4, R. Koleksi Jurnal |
| No. Panggil | No. Barkod | Ketersediaan |
|---|---|---|
| 610 UI-IJIM 50:3 (2018) | 03-19-312438724 | TERSEDIA |
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| Tidak ada ulasan pada koleksi ini: 20497878 |
