Successful Treatment of a Case of Crescentic Glomerulonephritis in a Patient with Primary Peritoneal Carcinoma: A case report

TL;DR

A patient with peritoneal cancer and severe kidney disease improved significantly after treatment with rituximab and steroids.

Contribution

This case report documents a rare instance of crescentic glomerulonephritis alongside peritoneal cancer and its successful treatment.

Findings

The patient's kidney function improved significantly after receiving rituximab and corticosteroids.

Proteinuria resolved within 10 weeks, and eGFR increased from 13 to over 60 mL/min.

Chemotherapy normalized the patient's CA-125 levels within three months.

Abstract

Crescentic glomerulonephritis has been associated with several solid tumour malignancies. Only a few cases of nephropathy have been reported in association with tubo-ovarian/peritoneal malignancies. We report a 55-year-old female patient who presented to a tertiary care centre, Muscat, Oman, in 2022. She developed combined immune complex-mediated glomerulonephritis and pauci-immune necrotising crescentic vasculitis simultaneously with the diagnosis of tubo-ovarian/peritoneal cancer. The baseline estimated glomerular filtration rate (eGFR) was 13 mL/min. The patient received two doses of rituximab and three doses of pulse corticosteroids, leading to significant improvement in renal function and the disappearance of her proteinuria. The eGFR improved to >60mL/min; her proteinuria gradually resolved after 10 weeks of treatment. She was then given a combination chemotherapy treatment for tubo-ovarian/peritoneal cancer leading to a normalisation of her CA-125 after three months of therapy.

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