Plasma exchange and rituximab treatments in primary membrano
Crescent formation is rare in primary membranous nephropathy (MN). Anti-phospholipase A2 receptor (PLA2R) antibodies are detectable in these patients. The mechanism and treatments are unknown.

A 72-year-old female patient who presented with nephrotic syndrome, hematuria, and rapidly progressive kidney dysfunction. Kidney biopsy was performed and the diagnosis was MN in combination with crescentic glomerulonephritis. Circulating anti-PLA2R IgG3 and IgG4 were detected of high level. The patient received plasma exchange and rituximab besides corticosteroids.

The patient achieved complete remission of proteinuria and recovery of kidney function after the clearance of anti-PLA2R antibodies.

Source: Medicine: May 2019 - Volume 98 - Issue 18 - p e15303

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