Adalimumab TNFα Inhibitor Therapy Exacerbates IgA Glomerulonephritis Acute Renal Injury and Induces Lupus Autoantibodies in a Psoriasis PatientReport as inadecuate




Adalimumab TNFα Inhibitor Therapy Exacerbates IgA Glomerulonephritis Acute Renal Injury and Induces Lupus Autoantibodies in a Psoriasis Patient - Download this document for free, or read online. Document in PDF available to download.

Case Reports in NephrologyVolume 2013 2013, Article ID 812781, 4 pages

Case Report

Kidney and Hypertension Clinic, St John of God Healthcare, Subiaco, WA, Australia

Department of General Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia

Department of Pathology, Royal Perth Hospital, Perth, WA, Australia

Received 14 May 2013; Accepted 7 July 2013

Academic Editors: J. Almirall, E. Comploj, and J. A. Sayer

Copyright © 2013 S. S. Wei and R. Sinniah. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Adalimumab Humira is a tumour necrosis factor α TNFα inhibitor that is approved for the treatment of rheumatoid arthritis, psoriasis, psoriatic arthritis, Crohn-s disease, ankylosing spondylitis, and juvenile idiopathic arthritis Sullivan and Preda 2009, Klinkhoff 2004, and Medicare Australia. Use of TNFα inhibitors is associated with the induction of autoimmunity systemic lupus erythematosus, vasculitis, and sarcoidosis or sarcoid-like granulomas Ramos-Casals et al. 2010. We report a patient with extensive psoriasis presenting with renal failure and seropositive lupus markers without classical lupus nephritis after 18 months treatment with adalimumab. He has renal biopsy proven IgA nephritis instead. Renal biopsy is the key diagnostic tool in patients presenting with adalimumab induced nephritis and renal failure. He made a remarkable recovery after adalimumab cessation and steroid treatment. To our knowledge, this is a unique case of a psoriasis patient presenting with seropositive lupus markers without classical lupus nephritis renal failure and had renal biopsy proven IgA glomerulonephritis after receiving adalimumab.





Author: S. S. Wei and R. Sinniah

Source: https://www.hindawi.com/



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