Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure

Tumor necrosis factor receptor associated periodic syndrome (TRAPS) is a rare monogenic autoinflammatory disease. Its most severe manifestation is secondary amyloidosis. A 44-year-old male presented with nephrotic syndrome. Kidney biopsy was conclusive for secondary amyloidosis. The patient and his...

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Main Authors: J. Coutinho, R. S. Chorão, M. Oliveira, C. R. Santos
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Nephrology
Online Access:http://dx.doi.org/10.1155/2019/6819476
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author J. Coutinho
R. S. Chorão
M. Oliveira
C. R. Santos
author_facet J. Coutinho
R. S. Chorão
M. Oliveira
C. R. Santos
author_sort J. Coutinho
collection DOAJ
description Tumor necrosis factor receptor associated periodic syndrome (TRAPS) is a rare monogenic autoinflammatory disease. Its most severe manifestation is secondary amyloidosis. A 44-year-old male presented with nephrotic syndrome. Kidney biopsy was conclusive for secondary amyloidosis. The patient and his children had a history of recurrent febrile periods since infancy. All subjects were positive for a heterozygous variant of the TNFRSF1A gene, confirming TRAPS diagnosis. The patient progressed to end-stage renal failure and developed recurrent pericarditis episodes. He was started on anakinra while on hemodialysis with marked reduction of his serum amyloid A protein (SAA) levels. Meanwhile he received a cadaveric renal transplant and maintains anakinra treatment. Despite renal failure being the most feared complication of AA amyloidosis caused by TRAPS, little data is available about safety of anti-IL-1 treatment in patients with severe kidney failure. The authors report this case of a patient on dialysis treated with anakinra in which no complications were registered. Though amyloidosis is established, the authors believe containing its progression and reducing inflammatory activity can improve patient prognosis and reduce recurrence of amyloidosis in kidney transplant, as has been demonstrated in transplanted patients due to familial Mediterranean fever amyloidosis.
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spelling doaj-art-7802f05a2b8f4149a01ebec74e1f922b2025-02-03T05:53:20ZengWileyCase Reports in Nephrology2090-66412090-665X2019-01-01201910.1155/2019/68194766819476Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal FailureJ. Coutinho0R. S. Chorão1M. Oliveira2C. R. Santos3Hospital Amato Lusitano, Castelo Branco, PortugalHospital Amato Lusitano, Castelo Branco, PortugalCentro Hospitalar Cova da Beira, Covilhã, PortugalHospital Amato Lusitano, Castelo Branco, PortugalTumor necrosis factor receptor associated periodic syndrome (TRAPS) is a rare monogenic autoinflammatory disease. Its most severe manifestation is secondary amyloidosis. A 44-year-old male presented with nephrotic syndrome. Kidney biopsy was conclusive for secondary amyloidosis. The patient and his children had a history of recurrent febrile periods since infancy. All subjects were positive for a heterozygous variant of the TNFRSF1A gene, confirming TRAPS diagnosis. The patient progressed to end-stage renal failure and developed recurrent pericarditis episodes. He was started on anakinra while on hemodialysis with marked reduction of his serum amyloid A protein (SAA) levels. Meanwhile he received a cadaveric renal transplant and maintains anakinra treatment. Despite renal failure being the most feared complication of AA amyloidosis caused by TRAPS, little data is available about safety of anti-IL-1 treatment in patients with severe kidney failure. The authors report this case of a patient on dialysis treated with anakinra in which no complications were registered. Though amyloidosis is established, the authors believe containing its progression and reducing inflammatory activity can improve patient prognosis and reduce recurrence of amyloidosis in kidney transplant, as has been demonstrated in transplanted patients due to familial Mediterranean fever amyloidosis.http://dx.doi.org/10.1155/2019/6819476
spellingShingle J. Coutinho
R. S. Chorão
M. Oliveira
C. R. Santos
Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
Case Reports in Nephrology
title Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
title_full Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
title_fullStr Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
title_full_unstemmed Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
title_short Treating TNF Receptor Associated Periodic Fever Syndrome in End-Stage Renal Failure
title_sort treating tnf receptor associated periodic fever syndrome in end stage renal failure
url http://dx.doi.org/10.1155/2019/6819476
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AT rschorao treatingtnfreceptorassociatedperiodicfeversyndromeinendstagerenalfailure
AT moliveira treatingtnfreceptorassociatedperiodicfeversyndromeinendstagerenalfailure
AT crsantos treatingtnfreceptorassociatedperiodicfeversyndromeinendstagerenalfailure