A rare case of MGRS with immunotactoid glomerulopathy responding to bortezomib, dexamethasone, and rituximab

Abstract

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Immunotactoid glomerulopathy: A rare glomerular disease case study

“…Patients present with proteinuria (nephrotic range in more than 60%), and over a half of the patients have hypertension, hematuria, CKD, and hematologic disorders. [ 1 , 6 – 8 ] The recurrence to allograft was seen in half of the transplanted patients, but usually with a more benign course. [ 5 ] In the largest available series of 73 patients with ITG, Nasr et al .…”

Polyclonal Immunotactoid Glomerulopathy Associated with Monoclonal Gammopathy of IgM Type and Underlying Plasmacellular Disease: Successful Treatment with Rituximab Alone

“…In general, successful therapy of an underlying hematologic malignancy may lead to complete remission of (the secondary) ITG [ 19 ], whereas on the other hand specific treatment has been deemed ineffective by others [ 29 ]. In a case of ITG associated with serum monoclonal IgM and a small, insignificant, monoclonal B-cell population Kuang et al [ 30 ] reported, that rituximab alone improved renal function and hypertension, but nephrotic syndrome only could be controlled by additional treatment with bortezomib and dexamethasone. Also, the long-term evolution of the glomerular disease has to be considered since it has been reported that a primarily polyclonal glomerular deposit may transform to a monoclonal pattern [ 31 ] and that there may be monoclonal recurrence of former polyclonal ITG after kidney transplantation [ 15 ].…”