Acute demyelinating neuropathy associated with rituximab treatment in a patient with relapsing nephrotic syndrome
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To the Editor,
Rituximab, the monoclonal antibody directed against CD20, represents ideal treatment of both membranous nephropathy (MN) and demyelinating neuropathy associated with antibodies to myelin-associated glycoprotein (MAG) [1, 2]. Clinical efficacy, safety, and modulating effects on normal and malignant pre-B and mature B cells have been reported [1, 2]. We encountered a 63-year-old woman who experienced acute onset of demyelinating polyneuropathy (AIDP) after rituximab infusions to treat her nephrotic syndrome (NS) . This patient presented 5 month history of peripheral swelling and microscopic haematuria. Laboratory tests showed normal creatinine (0.8 mg/dl), heavy proteinuria (6 g/daily), and negative screening for secondary causes of MN . Renal biopsy showed diffuse thickening of glomerular capillary basement membrane with basement membrane spikes and subepithelial granular deposits of IgG and C3 on immunofluorescence. She had circulating anti-phospholipase A2...
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The authors have declared that no conflict of interest exists.
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This article does not contain any studies with human participants performed by any of the authors.
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