Daratumumab for Bortezomib-Refractory Proliferative Glomerulonephritis With Monoclonal Immunoglobulin Deposits in Kidney Allograft: A Case Report

Despite treatment with immunosuppressive or clone-targeted chemotherapy, patients with proliferative glomerulonephritis with monoclonal immunoglobulin deposit (PGNMID) frequently progress into end-stage kidney failure, and early recurrence of PGNMID after kidney transplantation is common. The standa...

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Bibliographic Details
Main Authors: Zewei Chen, Shangxi Fu, Jun Wu, Xiaoling Luo, Zhiguo Mao, Dechao Xu, Xiang Gao
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Kidney Medicine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2590059524001560
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Summary:Despite treatment with immunosuppressive or clone-targeted chemotherapy, patients with proliferative glomerulonephritis with monoclonal immunoglobulin deposit (PGNMID) frequently progress into end-stage kidney failure, and early recurrence of PGNMID after kidney transplantation is common. The standard management of PGNMID has been unclear, currently based on data from small cohorts, which requires a need for additional therapeutic regimens in this disease. A human IgG monoclonal antibody that targets CD38 (daratumumab) was recently identified as a potential therapeutic option for treating PGNMID. To date, rare data on the application of daratumumab in patients with PGNMID after kidney transplantation have been reported. Herein, we first described a unique patient with recurrent PGNMID in kidney allograft who was treated with daratumumab after not responding to bortezomib-based regimens. Daratumumab was shown to successfully reduce proteinuria with stabilizing kidney function and was well-tolerated in this patient, which supports that daratumumab appears to be a viable option for treatment-resistant PGNMID.
ISSN:2590-0595