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- W3007520673 abstract "A 48-year-old man was diagnosed with PLA2R antibody positive membranous nephropathy. He had nephrotic range proteinuria quantitated at 13 g per day. Anti-CD 20 treatment was initiated, however there was concern for excessive renal excretion of rituximab given the patient’s significant proteinuria, which could theoretically result in attenuated therapeutic effect. Serum and urine protein electrophoresis were performed shortly after initial rituximab dosing, demonstrating a small monoclonal IgG kappa band likely representing the presence of rituximab. The urinary band was too small to quantitate via electrophoresis, and ELISA was postulated as an alternative means of quantification. The aim was to obtain serum peak and trough levels, as well as urinary levels, to estimate serum half-life and renal excretion in comparison to rituximab pharmacokinetics in patients without nephrotic-range proteinuria. This case study adds to the existing scant literature suggesting that patients with nephrotic syndrome experience significant rituximab losses into the urine1,2 and achieve lower serum rituximab levels as a consequence.3 Rituximab is used extensively for a variety of conditions, and information regarding pharmacokinetics in patients with proteinuria could affect critical decisions around dosing and route of administration. References1.Stahl K, Duong M, Schwarz A, et al. Kinetics of rituximab excretion into urine and peritoneal fluid in two patients with nephrotic syndrome. Case Rep Nephrol 2017; 2017: 1–8.2.Jacobs R, Langer-Jacobus T, Duong M, et al. Detection and quantification of rituximab in the human urine. J Immunol Methods 2017; 451: 118–21.3.Fervenza FC, Abraham RS, Erickson SB, et al. Rituximab therapy in idiopathic membranous nephropathy: a 2-year study. Clin J Am Soc Nephrol 2010; 5: 2188–98." @default.
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- W3007520673 date "2020-02-01" @default.
- W3007520673 modified "2023-09-25" @default.
- W3007520673 title "Estimating urinary losses of rituximab in membranous nephropathy with nephrotic range proteinuria" @default.
- W3007520673 doi "https://doi.org/10.1016/j.pathol.2020.01.149" @default.
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