Ofatumumab in post-transplantation recurrence of focal segmental glomerulosclerosis in a child

Pediatr Transplant. 2019 Jun;23(4):e13413. doi: 10.1111/petr.13413. Epub 2019 Apr 11.

Abstract

FSGS is a potentially devastating form of nephrotic syndrome. Treatment of SRNS can be difficult, especially post-transplantation. The current therapy of post-transplant SRNS includes plasmapheresis, ACE-I, CNI, and monoclonal antibodies (rituximab). Patients who are refractory to these interventions have limited therapeutic alternatives. We present a case of a patient with SRNS secondary to FSGS. He did not respond to immunosuppressive medications prior to transplant, progressed to ESRD, and was started on chronic hemodialysis. He received a DDKT which was complicated by post-transplant FSGS recurrence. A course of plasmapheresis, rituximab, and CNI were administered with some response. Ofatumumab was then given to the patient. As a result, the patient achieved partial remission. Ofatumumab may be a safe and effective option for post-transplant recurrence of FSGS.

Keywords: FSGS; Ofatumumab; Renal Transplant.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents / therapeutic use
  • Asthma / complications
  • Disease Progression
  • Eczema / complications
  • Glomerulosclerosis, Focal Segmental / complications
  • Glomerulosclerosis, Focal Segmental / drug therapy*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / adverse effects*
  • Male
  • Nephrotic Syndrome / complications
  • Nephrotic Syndrome / surgery*
  • Plasmapheresis
  • Postoperative Complications
  • Postoperative Period
  • Recurrence
  • Renal Dialysis
  • Rituximab / therapeutic use
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Immunosuppressive Agents
  • Rituximab
  • ofatumumab