Efficacy of rituximab in thymoma associated minimal change disease: case report.
BMC Nephrol
; 22(1): 303, 2021 09 07.
Article
in En
| MEDLINE
| ID: mdl-34493204
ABSTRACT
BACKGROUND:
Thymomas have been associated with a broad spectrum of autoimmune diseases. Minimal change disease (MCD) is the most frequent pathological lesion reported. Pathophysiological mechanisms involved in secondary MCD, and linking MCD to thymoma are not yet fully explained, although the hypothesis of T cell dysfunction has been suggested. The fundamental therapeutic principles are steroids and surgical treatment of thymoma, but failures and relapses often require immunosuppressant combinations. CASE PRESENTATION A 62-year-old female was admitted in our unit for a nephrotic syndrome associated with a thymoma. The diagnosis of thymoma associated MCD was confirmed by kidney biopsy. After surgical resection of the thymoma and steroid therapy, no remission was observed. Immunosuppressive therapy was then intensified with introduction of rituximab. Here, we report a steroid-resistant nephrotic syndrome secondary to MCD associated thymoma, which achieved complete remission after rituximab therapy. To the best of our knowledge, this is the first report of the use and efficacy of rituximab therapy in this pathology.CONCLUSIONS:
Our case report suggests that primary and secondary MCD may share similar pathophysiological mechanisms. It does not allow us to draw any conclusions about the mechanism of action of rituximab, but we believe this report argues for the safety and efficacy of rituximab use in thymoma-associated MCD, and therefore constitutes a rationale for future studies.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Thymoma
/
Thymus Neoplasms
/
Rituximab
/
Immunologic Factors
/
Nephrosis, Lipoid
Type of study:
Etiology_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Middle aged
Language:
En
Journal:
BMC Nephrol
Journal subject:
NEFROLOGIA
Year:
2021
Document type:
Article
Affiliation country:
Francia