How to treat RPGN with HCV?
A 48-year-old presents with rapidly progressive glomerulonephritis (RPGN) requiring dialysis and is found to have hepatitis C (HCV) with a high viral load. Serum complements are low, and the rheumatoid factor is positive. A renal biopsy shows a crescentic glomerulonephritis with immunoglobulin M (IgM) dominance. While cryoglobulins are pending, do you begin plasmapheresis followed by rituximab? Or is hepatitis C anti-viral therapy alone enough? What therapies are best and when should you start and end them? Share your thoughts.
Summary provided by Roger Rodby, MD, FASN.
Previous Community Minded Summaries are available at: https://community.asn-online.org/browse/communityminded