A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis.
| Autor: | Plant R; Nephrology, University Hospital Galway, Galway, IRL., Rafi Ahmed A; Nephrology, University Hospital Galway, Galway, IRL.; Health Sciences, University of South Wales, Newport, GBR., Mchale T; Pathology and Laboratory Medicine, University Hospital Galway, Galway, IRL., Giblin L; Nephrology, University Hospital Galway, Galway, IRL. |
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| Jazyk: | angličtina |
| Zdroj: | Cureus [Cureus] 2021 Jun 28; Vol. 13 (6), pp. e15986. Date of Electronic Publication: 2021 Jun 28 (Print Publication: 2021). |
| DOI: | 10.7759/cureus.15986 |
| Abstrakt: | Adalimumab is a monoclonal antibody targeting tumour necrosis factor-alpha (TNF-alpha) and is used for the treatment of numerous autoimmune conditions. There is a paucity of evidence linking adalimumab with granulomatous interstitial nephritis (GIN). We describe a renal biopsy-proven case of GIN secondary to adalimumab therapy. A 52-year-old gentleman with a background of psoriatic arthropathy was referred to the nephrology department by his general practitioner with a progressive decline in renal function over 18 months after initiating adalimumab. A renal biopsy confirmed tubulointerstitial nephritis with focal aggregates of histiocytes, organized as granulomata. Screening for other GIN causing aetiology, including tuberculosis (TB) and sarcoidosis, was negative. Adalimumab was withheld, leading to a slow improvement in renal function over a course of six months. It is essential to monitor renal function when administrating anti-TNF alpha agents as they can rarely paradoxically cause autoimmune reactions such as GIN seen in our case. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2021, Plant et al.) |
| Databáze: | MEDLINE |
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