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A 14-year-old boy exhibited lack of efficacy to cyclophosphamide and rituximab during treatment for class III lupus nephropathy [not all dosages stated; routes not stated]. The boy with an acute renal failure and nephrotic syndrome, was treated with haemodialysis due to dialysis urgency. Later, he was diagnosed with systemic lupus erythematosus and started receiving methylprednisolone, unspecified steroid, mycophenolate and cyclophosphamide 750 mg/m 2 . During hospitalisation, he experienced cytomegalovirus infection [aetiology not stated] and due to persistent activity gamma globulin, he received plasmapheresis for 5 sessions. Later, he developed thrombotic microangiopathy and again received 5 sessions of plasmapheresis. Thereafter, a diagnosis of class III lupus nephropathy was made. Later, he received 6 boluses of cyclophosphamide. However, proteinuria persisted in nephrotic range, indicating lack of efficacy to cyclophosphamide. Therefore, the boy started receiving rituximab 375 mg/m 2 every 4 weeks. However, he exhibited refractoriness to rituximab. An electron microscopy showed effacement of filtration diaphragms, consistent with lupus podocytopathy. Thereafter, he started re

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Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)