达雷妥尤单抗治疗伴单克隆免疫球蛋白沉积的增生性肾小球肾炎一例

Daratumumab in the treatment of proliferative glomerulonephritis with monoclonal immunoglobulin deposition:a case report

本文报道1例少见的伴有单克隆免疫球蛋白沉积的增生性肾小球肾炎。患者为49岁女性,临床表现为肾病综合征,肾活检病理提示伴单克隆免疫球蛋白(IgG3-κ)沉积的增生性肾小球肾炎。初治给予地塞米松+环磷酰胺+沙利度胺(CTDa)方案完全缓解,复发后予以硼替佐米+地塞米松(BD)方案治疗无效,且出现肾功能异常,调整为达雷妥尤单抗治疗后病情逐步缓解,肾功能恢复正常。

This article presents report a rare case of proliferative glomerulonephritis with monoclonal immunoglobulin deposition.The patient was a 49-year-old female,the clinical manifestations were nephrotic syndrome,Renal biopsy pathology indicated proliferative glomerulonephritis with monoclonal immunoglobulin(IgG3-k)deposition.Dexamethasone+cyclophosphamide+thalidomide(CTDa)regimen provided complete remission at the initial treatment,but bortezomib+dexamethasone(BD)regimen was ineffective after recurrence,and renal function abnormalities occurred.After daratumumab therapy,the disease gradually remission and renal function returned to normal.