Double Glomerulonephritis in a Patient with Ankylosing Spondylitis Treated with Biologic Agent: Extrarticolar Involvement or Anti-Tumor Necrosis Factor Alpha Injury? A Case-Based Review.

Autor: Diena D; Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Priora M; Division of Rheumatology, University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Barreca A; Division of Pathology, Department of Medical Sciences, University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Parisi S; Division of Rheumatology, University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Colla L; Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Biancone L; Division of Nephrology Dialysis and Transplantation, Department of Medical Sciences, University of Turin, Italy University Hospital 'Città della Salute e della Scienza,' Turin, Italy., Fusaro E; Division of Rheumatology, University Hospital 'Città della Salute e della Scienza,' Turin, Italy.
Jazyk: angličtina
Zdroj: Clinical medicine insights. Case reports [Clin Med Insights Case Rep] 2020 Nov 20; Vol. 13, pp. 1179547620974672. Date of Electronic Publication: 2020 Nov 20 (Print Publication: 2020).
DOI: 10.1177/1179547620974672
Abstrakt: With the widespreading use of biologic drugs, reports of renal injury are increasing, most of which belong to the spectrum of secondary autoimmune syndromes. We present the case of a young man affected by Ankylosing Spondylitis, treated with tumor necrosis factor alpha inhibitors (Anti-TNF) that develop a peculiar renal damage: a coexistence of 2 glomerulonephritis due to different noxae, an IgA nephropaty with a Membranous nephropathy. The first one probably related to the rheumatologic disease, the second one related to Anti-TNF. Despite the underlying mechanisms, the renal involvement both related to Ankylosing Spondylitis and secondary to biologic treatment are currently rare and not predictable. Regular control of renal function and urinalysis during treatment with anti-TNF is mandatory. A concomitant treatment with Disease Modifying Anti Rheumatic Drugs or eventually a low dose of steroids may prevent the formation of anti-drug antibodies and could limit the renal damage related to this phenomenon.
Competing Interests: Declaration of conflicting interests:The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
(© The Author(s) 2020.)
Databáze: MEDLINE
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