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. 2023 Jan 10;9(1):e002742. doi: 10.1136/rmdopen-2022-002742

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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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CD20-negative antibody-secreting cells are present in the kidney after rituximab treatment. Tissue sections of a kidney biopsy from patient 1 24 days before the initiation of daratumumab show ongoing crescentic glomerulonephritis (PAS, periodic acid–Schiff staining (×10)). No CD20-positive cells were detected in the kidney (10×, 20×), consistent with previous rituximab treatment. However, antibody-secreting cells, indicated by their expression of the kappa or lambda immunoglobulin light chains and CD138 (×20), are still found in the kidney.