Obinutuzumab in Refractory Phospholipase A2 receptor-Associated Membranous Nephropathy With Severe CKD

Currently, there are limited options for managing M-Type anti-phospholipase A2 receptor (PLA2R) antibody-associated membranous nephropathy (MN) with severe chronic kidney disease (CKD) (stage 4/5).(1,2) Obinutuzumab, a humanized type II anti-CD20 receptor antibody, induces more profound and long-lasting B-lymphocyte depletion, culminating in superior clinical response in patients with chronic lymphocytic leukaemia.(3) In the present manuscript, we report two cases of refractory (cyclical cyclophosphamide and corticosteroids (CYC/CS) and rituximab) MN with severe CKD managed successfully with Obinutuzumab.