Abstract
This is the time of paradigm shift in the treatment of primary membranousnephropathy which carries a major position in causing nephrotic syndrome in adult population and has been labelled as a cause of idiopathic primary glomerulonephropathy in about 90% of patients.It is two folds more common in male population as compared to female population.It is held responsible for about 0.7% cases of end stage kidney disease.However, unfortunately, the optimal treatmentfor idiopathic membranous nephropathy is still unresolved. Rituximabhas been made especiallyto attach to CD20 receptors and therefore cause depletion of B cells.Ithas been found to be a potential treatment option for idiopathicmembranous nephropathy.We present four cases of primary idiopathic membranous nephropathy that were successfullytreated with rituximab.They were all previously treated with conservative management followed by immunosuppression therapies but none of them was fortunate enough to achieve partial or complete remission.Therefore, all of them were given two doses of rituximab (375mg/m2),two weeks apart.Except for only one of the patientswho required a second round of rituximab therapy, they all achieved complete remission of the disease without any significant side effects of the drug. This representsthat those patients of idiopathic membranous nephropathy who are refractorycases with use of steroids, calcineurininhibitors, (cyclosporine or tacrolimus) or alkylating agents (cyclophosphamide or chlorambucil) still havea hope in the form of Rituximab which has no doubt shown promising results in Pakistani population. Indeed,Rituximab may also be used early in the course of the disease to improve the outcome of the disease
Zahid Nabi, Muhammad Adeel Alam, Nosheen Anjum, , Zahid Nabi, , Muhammad Adeel Alam. (2019) RITUXIMAB IN THE TREATMENT OF REFRACTORY IDIOPATHIC MEMBRANOUS NEPHROPATHY IN PAKISTANI POPULATION, JOURNAL OF AYUB MEDICAL COLLEGE ABBOTTABAD, Volume 31, Issue 2.
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