Successful treatment of adult-onset collapsing focal segmental glomerulosclerosis with rituximab

Abstract

Collapsing focal segmental glomerulosclerosis (FSGS), or collapsing glomerulopathy (CG), responds poorly to commonly employed therapies, with a high proportion of patients progressing to end-stage renal disease. We report an adult in a nephrotic state, diagnosed with minimal-change disease on biopsy, who failed to respond to steroids, calcineurin inhibitors (CNIs), mycophenolate mofetil and cyclophosphamide. Repeat biopsy showed CG. Treatment with 4 weekly doses of rituximab led to sustained remission of his nephrotic state. This is the first report of adult-onset CG that has responded favourably to rituximab. Rituximab could be a treatment option for patients with this difficult-to-treat condition. © 2013 © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please email: journals.permissions@oup.com.