关键词: 奥妥珠单抗, 微小病变肾病, 抗 nephrin 抗体

Abstract: A 17⁃year⁃old male patient presented with nephrotic syndrome.Renal biopsy revealed extensive foot process effacement (>90%) and cytoplasmic phagolysosomes in glomerular podocytes under the electron microscope,indicating a diagnosis of minimal change disease (MCD).Despite 8 weeks of full⁃dose corticosteroids,the patient exhibited persistent massive proteinuria,indicating steroid⁃resistant MCD.Serological testing revealed positive anti⁃nephrin antibody with a titer of 1∶30.After treatment with obinutuzumab (1g infusions for 2 doses),the patient achieved rapid remission of proteinuria and negative conversion of anti⁃nephrin IgG antibody.Corticosteroids were successfully tapered and discontinued over 5 months.Sustained remission of nephrotic syndrome has been achieved with obinutuzumab (1g) as maintenance therapy.