Moura AF, Rocha PN, Moura-Landim D, Moura Jr JA, Moura-Neto JA. Five-year follow-up sustained remission with rituximab in a patient with focal segmental glomerulosclerosis: A case report. World J Nephrol 2026; 15(1): 116620 [DOI: 10.5527/wjn.v15.i1.116620]
Corresponding Author of This Article
Ana Flávia Moura, MD, PhD, FASN, Department of Medicine, Bahiana School of Medicine and Public Health, Av D. Joao VI, Salvador 40290-000, Bahia, Brazil. anaflaviapsouza@gmail.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 25, 2026 (publication date) through Mar 14, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Nephrology
ISSN
2220-6124
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Moura AF, Rocha PN, Moura-Landim D, Moura Jr JA, Moura-Neto JA. Five-year follow-up sustained remission with rituximab in a patient with focal segmental glomerulosclerosis: A case report. World J Nephrol 2026; 15(1): 116620 [DOI: 10.5527/wjn.v15.i1.116620]
World J Nephrol. Mar 25, 2026; 15(1): 116620 Published online Mar 25, 2026. doi: 10.5527/wjn.v15.i1.116620
Five-year follow-up sustained remission with rituximab in a patient with focal segmental glomerulosclerosis: A case report
Ana Flávia Moura, Paulo Novis Rocha, Daniela Moura-Landim, Jose A Moura Jr, José A Moura-Neto
Ana Flávia Moura, Daniela Moura-Landim, José A Moura-Neto, Department of Medicine, Bahiana School of Medicine and Public Health, Salvador 40290-000, Bahia, Brazil
Paulo Novis Rocha, Department of Medicine and Diagnostic Support, School of Medicine of Bahia, Federal University of Bahia, Salvador 40110-100, Bahia, Brazil
Jose A Moura Jr, Department of Nephrology, Nephrology and Hypertension Institute, Salvador 40110-100, Bahia, Brazil
Author contributions: Moura AF contributed to data collection, writing - original draft; Rocha PN contributed to data collection critical review of the manuscript; Moura-Landim D contributed to data curation, literature review, manuscript editing; Moura Jr JA contributed to clinical supervision, writing - review and editing; Moura-Neto JA contributed to project administration, patient follow-up, critical revision of the manuscript, final approval; Moura AF and Rocha PN contributed to conceptualization, patient management.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ana Flávia Moura, MD, PhD, FASN, Department of Medicine, Bahiana School of Medicine and Public Health, Av D. Joao VI, Salvador 40290-000, Bahia, Brazil. anaflaviapsouza@gmail.com
Received: November 17, 2025 Revised: December 1, 2025 Accepted: December 23, 2025 Published online: March 25, 2026 Processing time: 118 Days and 15.9 Hours
Abstract
BACKGROUND
Focal segmental glomerulosclerosis (FSGS) represents a major cause of nephrotic syndrome, with glucocorticoids constituting first-line therapy. When patients develop steroid dependence or resistance, calcineurin inhibitors (CNIs) serve as effective alternatives. However, CNI dependence or resistance may emerge, and prolonged use of either steroid or CNI therapy carries substantial toxicity risks. These limitations create an unmet need for safer treatments capable of maintaining durable remission.
CASE SUMMARY
The patient initially presented with acute anasarca, nephrotic-range proteinuria (5.6 g/24 hours), hypoalbuminemia (2.1 g/dL), and preserved renal function. She experienced repeated relapses after corticosteroid and cyclosporine tapering, ultimately exhibiting a steroid- and CNI-dependent disease course. Rituximab was administered as two 1 g infusions 14 days apart, resulting in complete remission sustained for five years.
CONCLUSION
This case contributes to the growing evidence supporting rituximab’s therapeutic potential in adult FSGS, while highlighting the need for randomized controlled trials to establish its efficacy and optimal use in this challenging patient population.
Core Tip: This case report describes a patient with steroid- and calcineurin inhibitor-dependent primary focal segmental glomerulosclerosis (FSGS) who achieved complete and sustained remission for five years following a two-dose regimen of rituximab (RTX). The case highlights the potential of RTX as a steroid- and calcineurin inhibitor-sparing agent in adult FSGS, particularly in patients with significant toxicity or dependence on standard immunosuppressive therapy. The extended follow-up adds valuable insight into the long-term efficacy and safety of RTX in this challenging population.
