Proliferative Glomerulonephritis with Monoclonal IgG Deposits and Refractory Ascites: Successful Treatment with Rituximab and Cell-free and Concentrated Ascites Reinfusion Therapy

A 49-year-old woman presented with nephrotic-range proteinuria, microhematuria, and moderate renal dysfunction. Diuretic-resistant refractory ascites associated with nephrotic syndrome were observed. Based on the histopathological findings, the patient was diagnosed with proliferative glomerulonephritis with monoclonal immunoglobulin G deposits (PGNMID). Rituximab was administered due to steroid and immunosuppressive drug resistance, and partial remission was achieved after six months. Cell-free and concentrated ascites reinfusion therapy (CART) performed to treat the refractory ascites improved the ascites and anasarca. Rituximab successfully treated the PGNMID, while CART effectively treated the refractory ascites associated with nephrotic syndrome.