Skip Navigation


NDT Advance Access originally published online on October 19, 2004
Nephrology Dialysis Transplantation 2004 19(12):3054-3061; doi:10.1093/ndt/gfh469
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
19/12/3054    most recent
gfh469v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (75)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Roccatello, D.
Right arrow Articles by Sena, L. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Roccatello, D.
Right arrow Articles by Sena, L. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Nephrol Dial Transplant Vol. 19 No. 12 © ERA-EDTA 2004; all rights reserved

Original Article

Long-term effects of anti-CD20 monoclonal antibody treatment of cryoglobulinaemic glomerulonephritis

Dario Roccatello1–3,, Simone Baldovino1,3, Daniela Rossi1,2, Morteza Mansouri1,3, Carla Naretto1,3, Mariella Gennaro1,3, Roberto Cavallo1, Mirella Alpa1, Piera Costanzo1, Osvaldo Giachino1, Gianna Mazzucco4 and Luigi Massimino Sena1,3

1 Centro Multidisciplinare di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Struttura Complessa a Direzione Universitaria di Immunologia Clinica (CMID), Ospedale S.G. Bosco, 2 Unità Operativa di Nefrologia e Immunopatologia, Ospedale Evangelico Valdese, 3 Dipartimento di Medicina ed Oncologia Sperimentale, Università di Torino and 4 Dipartimento di Scienze Biomediche ed Oncologia Umana, Università di Torino, Turin, Italy

Correspondence and offprint requests to: Dario Roccatello, Centro Multidisciplinare di Ricerche di Immunopatologia e Documentazione su Malattie Rare, Struttura Complessa a Direzione Universitaria di Immunologia Clinica (CMID), Ospedale S. G. Bosco, P.zza del Donatore di Sangue 3, 10152 Torino, Italy. Email: dario.roccatello{at}unito.it

Background. Type II mixed cryoglobulinaemia (MC) is a systemic vasculitis, associated in most cases with hepatitis C virus (HCV) infection, and sustained by proliferation of oligoclonal cells. Systemic B-cell depletion and clinical remission can be achieved in non-Hodgkin lymphoma by a human/mouse chimeric monoclonal antibody that specifically reacts with the CD20 antigen (Rituximab). Similar effects could be expected in type II MC.

Methods. Six patients, mean age 64.2 years (range: 37–76 years), with HCV infection genotype 2a2c (three cases) or 1b (three cases) and symptomatic type-II MC with systemic manifestations, including renal involvement (five cases) and bone marrow clonal restriction (three cases), were considered eligible for Rituximab therapy. Rituximab was administered intravenously at a dose of 375 mg/m2 on days 1, 8, 15 and 22. Two more doses were administered 1 and 2 months later. No other immunosuppressive drugs were added. Response was evaluated by assessing the changes in clinical signs, symptoms and laboratory parameters for ≤18 months.

Results. Levels of proteinuria, erythrocyte sedimentation rate and cryocrit significantly decreased at 2, 6 and 12 months. Rheumatoid factor and IgM significantly decreased at 6 months whereas C4 values significantly increased at 2 and 6 months. HCV viral load and immunoglobulin G remained stable. Bone marrow abnormalities were found to reverse to normal in all three positive cases. Constitutional symptoms (skin ulcers, purpura, arthralgia, weakness, paraesthesia and fever) disappeared or improved. No acute or delayed side effects were observed.

Conclusions. Rituximab appears to be a safe and effective therapeutic option in symptomatic patients with HCV-associated MC glomerulonephritis and signs of systemic vasculitis.

Keywords: anti-CD20 monoclonal antibody; glomerulonephritis; Rituximab; type II mixed cryoglobulinaemia


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 J. Am. Soc. Nephrol.Home page
S. H. Nasr, A. Satoskar, G. S. Markowitz, A. M. Valeri, G. B. Appel, M. B. Stokes, T. Nadasdy, and V. D. D'Agati
Proliferative Glomerulonephritis with Monoclonal IgG Deposits
J. Am. Soc. Nephrol., September 1, 2009; 20(9): 2055 - 2064.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
D E Furst, E C Keystone, B Kirkham, R Fleischmann, P Mease, F C Breedveld, J S Smolen, J R Kalden, G R Burmester, J Braun, et al.
Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2008
Ann Rheum Dis, December 1, 2008; 67(Suppl_3): iii2 - iii25.
[Full Text] [PDF]

Home page
 Ann Rheum DisHome page
L Quartuccio, S Salvin, M Fabris, S Sacco, and S De Vita
Disappearance of bone marrow B cell clonal expansion in patients with type II hepatitis C virus-related cryoglobulinemic glomerulonephritis after clinical efficient rituximab therapy
Ann Rheum Dis, October 1, 2008; 67(10): 1494 - 1495.
[Full Text] [PDF]

Home page
 Ann Rheum DisHome page
D Saadoun, M Resche-Rigon, D Sene, L Perard, A Karras, and P Cacoub
Rituximab combined with Peg-interferon-ribavirin in refractory hepatitis C virus-associated cryoglobulinaemia vasculitis
Ann Rheum Dis, October 1, 2008; 67(10): 1431 - 1436.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
D. Saadoun, M. Rosenzwajg, D. Landau, J. C. Piette, D. Klatzmann, and P. Cacoub
Restoration of peripheral immune homeostasis after rituximab in mixed cryoglobulinemia vasculitis
Blood, June 1, 2008; 111(11): 5334 - 5341.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
P Cacoub, A Delluc, D Saadoun, D A Landau, and D Sene
Anti-CD20 monoclonal antibody (rituximab) treatment for cryoglobulinemic vasculitis: where do we stand?
Ann Rheum Dis, March 1, 2008; 67(3): 283 - 287.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
L. Quartuccio, M. Fabris, S. Salvin, M. Isola, F. Soldano, E. Falleti, C. A. Beltrami, V. De Re, and S. De Vita
Bone marrow B-cell clonal expansion in type II mixed cryoglobulinaemia: association with nephritis
Rheumatology, November 1, 2007; 46(11): 1657 - 1661.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
D. Saadoun, D. A. Landau, L. H. Calabrese, and P. P. Cacoub
Hepatitis C-associated mixed cryoglobulinaemia: a crossroad between autoimmunity and lymphoproliferation
Rheumatology, August 1, 2007; 46(8): 1234 - 1242.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Pathol.Home page
J. Kowalewska, A. S. Muhlfeld, K. L. Hudkins, M. M. Yeh, A. G. Farr, J. V. Ravetch, and C. E. Alpers
Thymic Stromal Lymphopoietin Transgenic Mice Develop Cryoglobulinemia and Hepatitis with Similarities to Human Hepatitis C Liver Disease
Am. J. Pathol., March 1, 2007; 170(3): 981 - 989.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
G. S Braun, S. Horster, K. S Wagner, S. Ihrler, and H. Schmid
Cryoglobulinaemic vasculitis: classification and clinical and therapeutic aspects
Postgrad. Med. J., February 1, 2007; 83(976): 87 - 94.
[Abstract] [Full Text] [PDF]

Home page
 BloodHome page
G. Lake-Bakaar, L. Dustin, J. McKeating, K. Newton, V. Freeman, and S. D.W. Frost
Hepatitis C virus and alanine aminotransferase kinetics following B-lymphocyte depletion with rituximab: evidence for a significant role of humoral immunity in the control of viremia in chronic HCV liver disease
Blood, January 15, 2007; 109(2): 845 - 846.
[Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
O. Bestard, J. M. Cruzado, G. Ercilla, M. Goma, J. Torras, D. Seron, I. Rama, M. Ibernon, O. Vinas, M. Carrera, et al.
Rituximab induces regression of hepatitis C virus-related membranoproliferative glomerulonephritis in a renal allograft
Nephrol. Dial. Transplant., August 1, 2006; 21(8): 2320 - 2324.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
L. Quartuccio, G. Soardo, G. Romano, F. Zaja, C. A. Scott, G. De Marchi, M. Fabris, G. Ferraccioli, and S. De Vita
Rituximab treatment for glomerulonephritis in HCV-associated mixed cryoglobulinaemia: efficacy and safety in the absence of steroids
Rheumatology, July 1, 2006; 45(7): 842 - 846.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
S. De Vita and L. Quartuccio
Rituximab as possible first-line therapy for glomerulonephritis in HCV-related mixed cryoglobulinaemia
Rheumatology, June 1, 2006; 45(6): 784 - 785.
[Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
O. M. R. Westwood, P. N. Nelson, and F. C. Hay
Rheumatoid factors: what's new?
Rheumatology, April 1, 2006; 45(4): 379 - 385.
[Full Text] [PDF]

Home page
 ASH Education BookHome page
E. Morra
Cryoglobulinemia
Hematology, January 1, 2005; 2005(1): 368 - 372.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.