A 37-year-old female patient presented with nephrotic syndrome,malar rash and serum positive antinuclear antibody.Renal biopsy showed mild mesangial proliferation with negative findings on IF and EM,EM showed diffuse effacement of the podocyte foot processes.She was diagnosed as lupus podocytopathy and was highly responsive to steroids treatment but she suffered from frequently relapse even in the combination therapy with prednisone plus other immunosuppressant.After the eighth relapse with nephrotic syndrome she received rituximab treatment and was followed up for 24 months,during which time she maintained complete remission even prednisone dosage was reduced to 5 mg/d.The successful treatment of this case indicates that rituximab may be effective in preventing the renal relapse of lupus podocytopathy.%37岁女性,临床表现为肾病综合征和抗核抗体阳性,肾活检光镜显示肾小球轻度系膜增生,免疫荧光未见免疫球蛋白和补体沉积,电镜观察见肾小球足细胞足突广泛融合,诊断为狼疮足细胞病.患者对激素治疗敏感,但是激素减量后即使联合多种免疫抑制剂,肾病综合征仍反复复发,且出现多种合并症.在第八次肾病综合征复发后给予利妥昔单抗治疗,此后随访24个月,患者尿检持续完全缓解,泼尼松剂量撤减至5 mg/d.利妥昔单抗有效预防了本例狼疮足细胞病的复发.
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