Five-year follow-up sustained remission with rituximab in a patient with focal segmental glomerulosclerosis: A case report
Year: 2026
Type: article
Study design: Case Report
Abstract: BACKGROUND: Focal segmental glomerulosclerosis (FSGS) represents a major cause of nephrotic syndrome, with glucocorticoids constituting first-line therapy. When patients develop steroid dependence or resistance, calcineurin inhibitors (CNIs) serve as effective alternatives. However, CNI dependence or resistance may emerge, and prolonged use of either steroid or CNI therapy carries substantial toxicity risks. These limitations create an unmet need for safer treatments capable of maintaining durable remission. CASE SUMMARY: The patient initially presented with acute anasarca, nephrotic-range proteinuria (5.6 g/24 hours), hypoalbuminemia (2.1 g/dL), and preserved renal function. She experienced repeated relapses after corticosteroid and cyclosporine tapering, ultimately exhibiting a steroid- and CNI-dependent disease course. Rituximab was administered as two 1 g infusions 14 days apart, resulting in complete remission sustained for five years. CONCLUSION: This case contributes to the growing evidence supporting rituximab's therapeutic potential in adult FSGS, while highlighting the need for randomized controlled trials to establish its efficacy and optimal use in this challenging patient population.
Source: World Journal of Nephrology
Language: English
Subfield: Nephrology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7135245356