{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:02:18Z","timestamp":1791666138808,"version":"4.3.4"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nephrol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Podocytopathies such as minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) remain therapeutic challenges in adults. Although corticosteroids and rituximab (RTX), a chimeric anti-CD20 monoclonal antibody, are effective in most patients, up to 10% show resistance or relapse despite B-cell depletion. Obinutuzumab (OBZ), a humanized type II anti-CD20 monoclonal antibody, achieves deeper and more sustained B-cell depletion and may overcome RTX inadequate response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>A 33-year-old woman presented with nephrotic syndrome (proteinuria 7.1 g\/24 h, serum albumin 2.6 g\/dL, preserved renal function). Kidney biopsy revealed primary FSGS. She achieved only partial remission with corticosteroids and cyclosporine. RTX (1 g \u00d7 2 doses) induced transient peripheral B-cell depletion but no complete remission. A second biopsy excluded chronic changes, and genetic testing for hereditary podocytopathy was negative. Thus 67 weeks after diagnosis and initial treatment with persistent proteinuria &amp;gt; 1g\/24 h and hypoalbuminemia, the patient received OBZ (1 g \u00d7 2 doses, two weeks apart). Two months later, she achieved complete remission (proteinuria 0.2 g\/24 h, serum albumin 3.7 g\/dL), with sustained B-cell depletion and no adverse events. A repeat administration of OBZ (1 g) was performed 10 months later due to B-cell repopulation, rising proteinuria (0.6 g\/24 h), and mild hypoalbuminemia (serum albumin 3.4 g\/dL), successfully re-inducing complete remission (proteinuria 0.2 g\/24 h, serum albumin 3.8 g\/dL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case illustrates the potential of OBZ as an effective therapeutic option in podocytopathies with RTX inadequate response. The superior efficacy of OBZ may result from enhanced antibody-dependent cellular cytotoxicity, depletion of tissue-resident B cells, and reduced immunogenicity compared with RTX. OBZ may thus offer an alternative in refractory MCD\/FSGS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneph.2026.1772736","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T05:22:37Z","timestamp":1772515357000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Successful use of obinutuzumab in focal segmental glomerulosclerosis with inadequate response to rituximab: a case report"],"prefix":"10.3389","volume":"6","author":[{"given":"Andreia Rita","family":"Henriques","sequence":"first","affiliation":[{"name":"Nephrology Department, Hospitais da Universidade de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o","family":"Venda","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospitais da Universidade de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuel","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospitais da Universidade de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]},{"name":"University of Coimbra, Faculty of Medicine","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuno","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospitais da Universidade de Coimbra, Unidade Local de Sa\u00fade de Coimbra","place":["Coimbra, Portugal"]},{"name":"University of Coimbra, Faculty of Medicine","place":["Coimbra, Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"S\u00e1","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospitais da Universidade de Coimbra, Unidade Local de Sa\u00fade de 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