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Submitted: 07 Oct 2018
Accepted: 14 Dec 2018
First published online: 09 Jan 2019
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J Nephropharmacol. 2019;8(1): e13.
doi: 10.15171/npj.2019.13
  Abstract View: 661
  PDF Download: 429

Case Report

Rituximab in ANCA-associated vasculitis presenting with severe acute kidney injury; a case report

Macaulay Onuigbo 1 * , Julius Seok 1, Ikenna Anyamene 2, Fortunate Ejimone 3, Chinenye Eze-Raphael 4, In-Ah Vanessa Park 1

1 The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA
2 University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
3 Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
4 University of Nigeria Teaching Hospital, Enugu, Nigeria
*Corresponding author: Macaulay Onuigbo, Email: Email: macaulay.onuigbo@uvmhealth.org

Abstract

Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis presenting with severe acute kidney injury (AKI), consistent with rapidly progressive glomerulonephritis portends significant renal morbidity with up to 20%–25% of patients reaching end stage renal disease within a few years after diagnosis. Nevertheless, a smaller proportion of patients require dialysis at presentation or within the first six months. There is still some debate as to the first line therapy of choice for such patients vis a vis the use of the newer agent rituximab versus the time-tested cyclophosphamide in combination with glucocorticoids. Our recent experience at The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA in June 2018 allowed us to revisit this controversy.
Keywords: Acute kidney injury, Anti-neutrophil cytoplasmic antibody, Rituximab, Vasculitis, Acute kidney injury, Pulmonary-renal syndrome

Implication for health policy/practice/research/medical education:

In the last decade, there has been an increasing interest in the exact role of intravenous rituximab in the management of ANCAassociated vasculitis presenting with severe acute kidney injury. We describe a recent experience at The Robert Larner, M.D. College of Medicine, University of Vermont, Burlington, VT, USA that enabled us to revisit this controversy. There is indeed a place for rituximab in combination with glucocorticoids in these circumstances.

Please cite this paper as: Onuigbo M, Seok J, Anyamene I, Ejimone F, Eze-Raphael C, Vanessa Park IA. Rituximab in ANCAassociated vasculitis presenting with severe acute kidney injury; a case report. J Nephropharmacol. 2019;8(1):e13. DOI: 10.15171/ npj.2019.13

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