[English Title : Treatment of membranous nephropathy].

Abstract

Membranous nephropathy (MN) is a frequent cause of nephrotic syndrome in adults. In recent years, many progresses have been made, both in terms of diagnosis and treatment. For diagnosis, the discovery of new antigens and diseases that may be associated with MN led to the establishment of a new classification of MNs. In terms of treatment, many progresses have also been made with increasingly effective management, particularly with the help of immunosuppressive drugs. However, there are still cases of MN refractory to conventional treatments. Numerous molecules are being developed to manage these refractory MNs. Among them, Obinutuzumab, a type II anti-CD20, allows a more profound depletion of B cells compared to Rituximab classically used in clinical routine. To illustrate this point, we present the case of a patient suffering from MN with anti-THSD7A antibodies in whom a clinical and biological improvement was observed with obinutuzumab, after failure of conventional therapies.