The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes
IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheuma...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2020/9480860 |
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| author | Vedran Premužić Ivan Padjen Mislav Cerovec Marijana Ćorić Bojan Jelaković Branimir Anić |
| author_facet | Vedran Premužić Ivan Padjen Mislav Cerovec Marijana Ćorić Bojan Jelaković Branimir Anić |
| author_sort | Vedran Premužić |
| collection | DOAJ |
| description | IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheumatoid arthritis (RA), which developed IgAN while receiving TNF-alpha inhibitors. All off our three patients had RA, which lasted 2–4 years, and none of them had a prior history of chronic kidney disease. Two patients were treated with adalimumab while one patient was treated with golimumab. Discontinuation of anti-TNF-alpha therapy and initiation of immunosuppressive therapy led to improvement in serologic abnormalities and renal function in two patients, while the third patient’s 24-hour proteinuria was only partially reduced, which supports previous reports on TNF-alpha inhibitor induced autoimmunity. Two of our patients had previously been diagnosed with type 2 diabetes mellitus while the third patient developed diabetes years after the onset of IgAN. This is in line with the previously described association of IgAN and diabetes mellitus. To our best knowledge, this is the first report to analyze the development of IgAN as a potential consequence of anti-TNF-alpha therapy and its possible association with pretreatment or posttreatment diabetes. |
| format | Article |
| id | doaj-art-fad071c2f80a4ce0a74f98b57d230410 |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Nephrology |
| spelling | doaj-art-fad071c2f80a4ce0a74f98b57d2304102025-02-03T01:27:04ZengWileyCase Reports in Nephrology2090-66412090-665X2020-01-01202010.1155/2020/94808609480860The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and DiabetesVedran Premužić0Ivan Padjen1Mislav Cerovec2Marijana Ćorić3Bojan Jelaković4Branimir Anić5Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaDepartment of Immunology and Rheumatology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaDepartment of Immunology and Rheumatology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaDepartment of Pathology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaDepartment of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaDepartment of Immunology and Rheumatology, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10 000, CroatiaIgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheumatoid arthritis (RA), which developed IgAN while receiving TNF-alpha inhibitors. All off our three patients had RA, which lasted 2–4 years, and none of them had a prior history of chronic kidney disease. Two patients were treated with adalimumab while one patient was treated with golimumab. Discontinuation of anti-TNF-alpha therapy and initiation of immunosuppressive therapy led to improvement in serologic abnormalities and renal function in two patients, while the third patient’s 24-hour proteinuria was only partially reduced, which supports previous reports on TNF-alpha inhibitor induced autoimmunity. Two of our patients had previously been diagnosed with type 2 diabetes mellitus while the third patient developed diabetes years after the onset of IgAN. This is in line with the previously described association of IgAN and diabetes mellitus. To our best knowledge, this is the first report to analyze the development of IgAN as a potential consequence of anti-TNF-alpha therapy and its possible association with pretreatment or posttreatment diabetes.http://dx.doi.org/10.1155/2020/9480860 |
| spellingShingle | Vedran Premužić Ivan Padjen Mislav Cerovec Marijana Ćorić Bojan Jelaković Branimir Anić The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes Case Reports in Nephrology |
| title | The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes |
| title_full | The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes |
| title_fullStr | The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes |
| title_full_unstemmed | The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes |
| title_short | The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes |
| title_sort | association of tnf alpha inhibitors and development of iga nephropathy in patients with rheumatoid arthritis and diabetes |
| url | http://dx.doi.org/10.1155/2020/9480860 |
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