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Abstract: SA-PO0898

A Case of Proliferative Glomerulonephritis with Monoclonal IgG Deposits (PGNMID) with Crescent Formation that Responds Favorably to Low-Dosage Daratumumab

Session Information

Category: Glomerular Diseases

  • 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

  • Wei, Xin, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
  • Yan, Yan, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
Introduction

Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a rare renal disease without standardized treatment modalities. Daratumumab is a human IgG monoclonal anti-CD38 antibody that has been demonstrated to be highly effective and safe in treating PGNMID.

Case Description

The patient is a middle-aged woman whose first kidney biopsy suggested proliferative glomerulonephritis. Despite receiving treatment with glucocorticoids, glucocorticoids combined with immunosuppressants, and rituximab, her condition continued to progress. Upon a second kidney biopsy, she was diagnosed with proliferative glomerulonephritis associated with monoclonal immunoglobulin deposition (IgG3 κ). The patient received a total dose of 400-800 mg of daratumumab every two weeks. After the first dose of daratumumab, her 24-hour proteinuria decreased from 12g to 4.38g, and serum creatinine levels dropped from 616umol/L to 342.8umol/L. Two months later, she was able to discontinue hemodialysis. After six months of follow-up, the kidney disease achieved complete remission, with no serious adverse reaction.

Discussion

In conclusion, this case underlines the potential of low-dose daratumumab as a viable option for PGNMID, even in severe cases presenting as rapidly progressive glomerulonephritis.

Fig1. Images from the renal biopsy

Fig2. Trends in patient urine protein and serum creatinine changes

Digital Object Identifier (DOI)