Collapsing glomerulopathy as a complication of interferon therapy for hepatitis C infection

Kanungo, Sriraj; Tamirisa, Srinath; Gopalakrishnan, Rajalakshmi; Salinas-Madrigal, Luis; Bastani, Bahar

doi:10.1007/s11255-009-9594-1

Cited by 12 publications

(13 citation statements)

References 9 publications

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“…IFN-α therapy has been implicated in various renal diseases such as renal thrombotic microangiopathy (in patients with chronic leukemia) [12], interstitial nephritis [13], and glomerular diseases including podocytopathies (focal segmental glomerulosclerosis and minimal change disease) or immune complex glomerulonephritis (membranous nephropathy, membrano-proliferative glomerulonephritis, IgA nephropathy), as shown in several case reports published over the last 20 years [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. In addition, case series have been published [31].…”

Section: Discussionmentioning

confidence: 99%

“…Additional papers provided evidence of exacerbation of pre-existing glomerular disease during IFN [32,33]. The usual presentation of glomerular disease associated with IFN is isolated proteinuria, and nephrotic syndrome [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. In a minority of patients, nephritic syndrome with renal failure has been recorded.…”

Section: Discussionmentioning

confidence: 99%

“…As listed in Table 2, these reports concerned mostly the treatment of haematological or solid neoplastic disorders, with dosages of interferon frequently higher than in the current case. Three other case reports on IFN-associated renal failure described focal ATN in kidney biopsy in association with glomerular abnormalities [14,30,40]. …”

Section: Discussionmentioning

confidence: 99%

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Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Fabrizi

Aghemo

Fogazzi

et al. 2013

Kidney Blood Press Res

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Background/Aims: Interferon treatment of malignant or viral diseases can be accompanied by various side-effects including nephro-toxicity. Methods: We report on a 68-year-old Caucasian male who received dual therapy with pegylated interferon 2a plus ribavirin for chronic hepatitis C. Results: After three months of antiviral therapy, the patient developed acute kidney failure (serum creatinine up to 6 mg/dL) with mild proteinuria (500 mg daily) and haematuria. Immediate immunosuppressive therapy with high-dose intravenous steroids did not improve kidney function. Kidney biopsy was consistent with acute tubular necrosis without glomerular abnormalities. He started long-term peritoneal dialysis (four regular exchanges) to provide both dialysis adequacy and ascites removal. Kidney function gradually improved over the following months (serum creatinine around 2 mg/dL) and peritoneal dialysis was continued with two exchanges daily. The temporal relationship between the administration of the drug and the occurrence of nephro-toxicity, and the absence of other obvious reasons for acute tubular necrosis support a causative role for pegylated interferon; benefit on kidney disease was noted after withdrawal of antiviral agents. An extensive review of the literature on acute tubular necrosis associated with interferon-based therapy, based on in vitro data and earlier case-reports, has been made. The proposed pathogenic mechanisms are reviewed. Conclusions: Our case emphasizes the importance of monitoring renal function during treatment of chronic hepatitis C with antiviral combination therapy as treatment may precipitate kidney damage at tubular level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Fabrizi

Aghemo

Fogazzi

et al. 2013

Kidney Blood Press Res

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“…Reports of FSGS after treatment with IFN have included FSGS of the usual type (FSGS NOS) (10 cases) and collapsing FSGS (three cases; Table 3). Among the 13 reported cases, at least 12 had full nephrotic syndrome and 11 had acute renal failure (with information about nephrotic parameters unavailable in one case) (30). Twelve patients were receiving IFN-␣, and one patient was being treated with IFN-␥.…”

Section: Discussionmentioning

confidence: 99%

Treatment with IFN-α, -β, or -γ Is Associated with Collapsing Focal Segmental Glomerulosclerosis

Markowitz¹,

Nasr²,

Stokes³

et al. 2010

Clinical Journal of the American Society of Nephrology

204

180

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Background and objectives: Treatment with IFN is rarely associated with nephrotic syndrome and renal biopsy findings of minimal-change disease or FSGS.Design, setting, participants, & measurements: We report 11 cases of collapsing FSGS that developed during treatment with IFN and improved after discontinuation of therapy.Results: The cohort consists of seven women and four men with a mean age of 48.2 yr. Ten of the 11 patients were black. Six patients were receiving IFN-␣ for hepatitis C virus infection (n ‫؍‬ 5) or malignant melanoma (n ‫؍‬ 1), three were receiving IFN-␤ for multiple sclerosis, and two were treated with IFN-␥ for idiopathic pulmonary fibrosis. After a mean and median duration of therapy of 4.0 and 12.6 months, respectively, patients presented with acute renal failure (mean creatinine 3.5 mg/dl) and nephrotic-range proteinuria (mean 24-hour urine protein 9.7 g). Renal biopsy revealed collapsing FSGS with extensive foot process effacement and many endothelial tubuloreticular inclusions. Follow-up was available for 10 patients, all of whom discontinued IFN. At a mean of 23.6 months, nine of 10 patients had improvement in renal function, including one with complete remission and two with partial remission. Among the seven patients with available data, mean proteinuria declined from 9.9 to 3.0 g/d. Four of the seven patients were treated with immunosuppression, and there was no detectable benefit.Conclusions: Collapsing FSGS may occur after treatment with IFN-␣, -␤, or -␥ and is typically accompanied by the ultrastructural finding of endothelial tubuloreticular inclusions. Optimal therapy includes discontinuation of IFN.

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“…Además se la ha asociado a algunas enfermedades autoinmunes como lupus y enfermedad de Still 15 . En forma más esporádica, se reporta asociación con algunos medicamentos como interferon Alfa 16 y bifosfonatos pero en el caso de estos últimos, sólo cuando son usados en dosis supraterapéuticas 17 . En frecuencia decreciente se ha descrito en pacientes post trasplante renal, asociado a neoplasias y de origen genético, siendo en todos los grupos más común entre población afroamericana, excepto en los relacionados a fármacos y en post trasplante donde se reportan más casos en población blanca 18 .…”

Section: Diagnóstico Y Etiologíaunclassified

Glomerulopatia colapsante

et al. 2012

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Collapsing glomerulopathy as a complication of interferon therapy for hepatitis C infection

Abstract: We present the case of a patient with chronic hepatitis C and diabetes, who rapidly progressed to end stage renal disease upon initiation of IFNalpha therapy for his HCV infection. A kidney biopsy revealed advanced collapsing glomerulopathy.

Cited by 12 publications

References 9 publications

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Treatment with IFN-α, -β, or -γ Is Associated with Collapsing Focal Segmental Glomerulosclerosis

Glomerulopatia colapsante

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