Abstract: FR-PO0727
Obinutuzumab Alone to Successfully and Rapidly Treat Refractory Minimal Change Disease in a Patient with ADPKD
Session Information
- Glomerular Diseases: Membranous Nephropathy, FSGS, and Podocytopathies
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Author
- Zheng, Danxia, Peking University Third Hospital, Beijing, China
Introduction
There are a few reports on the monotherapy of obinutuzumab for nephrotic syndrome (NS) of minimal change disease (MCD)(1). Here, we present a boy with ADPKD who developed NS due to MCD, and he was treated with obinutuzumab two times with and without corticosteroids, both successfully and rapidly.
Case Description
A 15-year-old boy was admitted to our hospital due to his persistent NS after methylprednisolone (MP) 48mg daily for 3 weeks.
3 weeks ago, this ADPKD boy (his renal multiple cysts and positive ADPKD family history) was diagnosed NS (urine protein (UP) 15.6g/24h, serum albumin (ALB) 17.6g/L). He was given oral MP 48mg daily for 3 weeks, but his UP was still 16.5 g/24h and serum ALB 15.9 g/L（see Figure 1).
During his hospitalization, we did: (1) Intravenous MP 40mg daily was given for 7 days. (2) a renal biopsy was performed and MCD was diagnosed (no ADPKD signs). (3) obinutuzumab 1g was given. (4) secondary causes of NS were checked and ruled out. Seven days later, his UP rapidly turned negative with serum ALB rose to 21.2g/L. He continued oral MP. Unfortunately, he suffered a severe pneumonia, but his MCD kept in complete remission during this period. MP was subsequently tapered and discontinued over the following months. He kept UP negative for several months.
27 months after his first onset, the patient found his UP changed positive and his UP was 6g/24h next day. Obinutuzumab 1g was given on the fourth day (when his UP 10.6g/24h, ALB 36g/L without edema). His NS developed, UP 13g/24h and ALB 19g/L 3 days after obinutuzumab and obvious edema, and UP 19g/24h and ALBs 19g/L 7 days after obinutuzumab.Luckily his UP turned negative (0.1g/24h) and ALB increased to 32g/L 14 days after obinutuzumab. Thereafter, no further treatment was given, and his UP kept negative (Showed in Figure 2).
Discussion
Why obinutuzumab as monotherapy showed a rapid and excellent efficacy in this young MCD patient. We analyzed, (1) obinutuzumab is much stronger and faster and deeper in sustaining B-cell depletion than rituximab. (2) obinutuzumab was used at the very early stage of MCD onset.