Remission of C3 glomerulopathy with rituximab as only immunosuppressive therapy

Clin Nephrol. 2015 Jan;83(1):57-60. doi: 10.5414/CN107945.

Abstract

C3 glomerulopathy (C3GP) is a membranoproliferative glomerulonephritis without immunoglobulin deposits. Activation of the alternative pathway of the complement system is central in its pathogenesis. The presence of a C3 nephritic factor (C3Nef), or deficient factor H or I is associated with C3 GP. The treatment is not codified. Here we describe a case of a Caucasian male with a dense deposit disease (a form of C3GP) revealed by nephritic syndrome. C3Nef was present. We treated him with rituximab as the sole immunosuppressive regimen and obtained a complete remission on proteinuria. The effect was sustained at more than 2 years with only two courses of treatment and an excellent tolerance. Rituximab could be proposed as a treatment of C3GP associated with antibodies interfering with complement alternative pathway.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use*
  • Biopsy
  • Face / pathology
  • Glomerulonephritis, Membranoproliferative / drug therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Kidney Glomerulus / pathology
  • Male
  • Remission Induction
  • Rituximab

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Immunosuppressive Agents
  • Rituximab