Nephrologist

[hassbeeb]

hi

can you you help me with this case.

patient is 27 yrs old who developed acute renal failure requirind dialysis.

Renal biopsy was done and showed double glomerulopathy with pauci-immune GN and membranous nephropathy.

She was advised for IV cyclophosphamide but refused due to fertility issues.

So, Rituximab was started 375mg/m2 weekly for 4 doses in addition to prednisolone 1 mg/kg/day.

what is next?

How to decide whether maintenance therapy should be given or not?

how long after the last Rituximab dose shall we wait to decide on therapy failure or the need for maintenance therapy?

Thanks for cooperation.

[LynneJ Vasculitis UK Volunteer]

Hi

I can only speak from my experience. I had rituximab 2 years ago and have stayed on azathioprine 150mg per day as maintenance. I have been told that this will extend the need for the next rituximab. So far so good. Latest bloods were normal. The only thing is I have had two chest infections over the last year. But they were sorted with antibiotics.

Good luck.

[Hidden]

Hi,

Are you asking because you the patient or because you are a clinician and are looking for advice?

[Suzym2u Moderator Vasculitis UK]

Hasseeb are you in the U.K.?

[hassbeeb]

no I am out of UK

[LeshaFarrar]

The uk guidelines for the treatment of ANCA vasculitis are here, you might find them useful ard.bmj.com/content/early/2...