Infliximab-associated focal segmental glomerulosclerosis in a patient with ankylosing spondylitis

Tuğsal, Handan Yarkan; Zengin, Berrin; Kenar, Gökçe; Can, Gerçek; Ünlü, Mehtat; Önen, Fatoş; Birlik, Ahmet Merih

doi:10.1007/s00296-019-04241-8

Cited by 9 publications

(3 citation statements)

References 22 publications

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“… 70 , 75 A possible case of infliximab-induced focal segmental glomerulosclerosis presenting as a severe nephrotic syndrome in a patient with UC has been described, 76 and a similar case in the setting of ankylosing spondylitis. 77 More data related to the possible renal side effects of anti-TNF therapy are needed, but available data suggest that renal complications are uncommon. 74 …”

Section: Drug-related Nephrotoxicitymentioning

confidence: 99%

Renal and Urological Disorders Associated With Inflammatory Bowel Disease

Kumar

Pollok

Goldsmith

2022

Inflammatory Bowel Diseases

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Renal and urinary tract complications related to inflammatory bowel disease (IBD) have been relatively understudied in the literature compared with other extraintestinal manifestations. Presentation of these renal manifestations can be subtle, and their detection is complicated by a lack of clarity regarding the optimal screening and routine monitoring of renal function in IBD patients. Urolithiasis is the most common manifestation. Penetrating Crohn’s disease involving the genitourinary system as an extraintestinal complication is rare but associated with considerable morbidity. Some biologic agents used to treat IBD have been implicated in progressive renal impairment, although differentiating between drug-related side effects and deteriorating kidney function due to extraintestinal manifestations can be challenging. The most common findings on renal biopsy of IBD patients with renal injury are tubulointerstitial nephritis and IgA nephropathy, the former also being associated with drug-induced nephrotoxicity related to IBD medication. Amyloidosis, albeit rare, must be diagnosed early to reduce the chance of progression to renal failure. In this review, we evaluate the key literature relating to renal and urological involvement in IBD and emphasize the high index of suspicion required for the prompt diagnosis and treatment of these manifestations and complications, considering the potential severity and implications of acute or chronic loss of renal function. We also provide suggestions for future research priorities.

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Section: Drug-related Nephrotoxicitymentioning

confidence: 99%

Renal and Urological Disorders Associated With Inflammatory Bowel Disease

Kumar

Pollok

Goldsmith

2022

Inflammatory Bowel Diseases

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“…Similarly, androgenic anabolic steroids can cause FSGS presenting as AKI with nephrotic proteinuria (Herlitz et al, 2010). The tumor necrosis factor‐alpha (TNF‐α) inhibitor infliximab has also been reported to cause FSGS in a patient who was found to have asymptomatic nephrotic range proteinuria and hematuria on routine follow up (Yarkan Tugsal et al, 2019).…”

Section: Overview Of Non‐genetic Causes Of Fsgsmentioning

confidence: 99%

Monogenic focal segmental glomerulosclerosis: A conceptual framework for identification and management of a heterogeneous disease

Sambharia

Rastogi

Thomas

2022

American J of Med Genetics Pt C

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Focal segmental glomerulosclerosis (FSGS) is not a disease, rather a pattern of histological injury occurring from a variety of causes. The exact pathogenesis has yet to be fully elucidated but is likely varied based on the type of injury and the primary target of that injury. However, the approach to treatment is often based on the degree of podocyte foot process effacement and clinical presentation without sufficient attention paid to etiology. In this regard, there are many monogenic causes of FSGS with variable presentation from nephrotic syndrome with histological features of primary podocytopathy to more modest degrees of proteinuria with limited evidence of podocyte foot process injury. It is likely that genetic causes are largely underdiagnosed, as the role and the timing of genetic testing in FSGS is not established and genetic counseling, testing options, and interpretation of genotype in the context of phenotype may be outside the scope of practice for both nephrologists and geneticists. Yet most clinicians believe that a genetic diagnosis can lead to targeted therapy, limit the use of high-dose corticosteroids as a therapeutic trial, and allow the prediction of the natural history and risk for recurrence in the transplanted kidney. In this manuscript, we emphasize that genetic FSGS is not monolithic in its presentation, opine on the importance of genetic testing and provide an algorithmic approach to deployment of genetic testing in a timely fashion when faced with a patient with FSGS.

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“…Renal abnormalities and kidney biopsy results are depicted in Τable 1 according to underlying disease and to the anti-TNF-α agent implicated. [8][9][10][11][12][13][14] Renal Involvement in the SpA Axial SpA-AS can be accompanied by extraarticular manifestations primarily of the cardiovascular and respiratory system. Renal disease is exceptionally rare.…”

Section: Dovepressmentioning

confidence: 99%

Glomerulonephritis in Two Patients with SpA Treated with TNF-α Blockers and a Review of the Literature

Bounia

Theodoropoulou

Liossis

2021

BTT

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Renal failure or acute/chronic kidney damage may present as a clinical manifestation of rheumatic diseases. In addition treatment with DMARDs or biologic drugs may induce nephrotoxicity. In this case-based review, we present two patients with SpA under anti-TNF-α treatment admitted to our hospital because of renal failure and proteinuria. We review previously published yet isolated cases of TNF-α blocker-induced glomerular disease in patients with SpA. Renal manifestations are occasionally seen in patients with ankylosing spondylitis and psoriatic arthritis with IgA nephropathy being the most common of them. Anti-TNF-α agents although reportedly used for the treatment of glomerular nephropathy as a disease manifestation, they have been considered responsible for provoking renal damage in some cases. A diagnostic approach for patients with SpA treated with anti-TNF-α agents presenting with renal manifestations is proposed herein.

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Infliximab-associated focal segmental glomerulosclerosis in a patient with ankylosing spondylitis

Cited by 9 publications

References 22 publications

Renal and Urological Disorders Associated With Inflammatory Bowel Disease

Renal and Urological Disorders Associated With Inflammatory Bowel Disease

Monogenic focal segmental glomerulosclerosis: A conceptual framework for identification and management of a heterogeneous disease

Glomerulonephritis in Two Patients with SpA Treated with TNF-α Blockers and a Review of the Literature

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