Reversal of refractory sulfasalazine-related renal failure after treatment with corticosteroids

Alivanis, Polichronis; Aperis, Georgios; Lambrianou, Fotini; Zervos, Angelos; Paliouras, Christos; Karvouniaris, Nikolaos; Arvanitis, Antonios

doi:10.1016/j.clinthera.2010.10.002

Cited by 21 publications

(10 citation statements)

References 15 publications

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“…Although parenchymal renal disease in IBD has been described [ 2 ], granulomatous interstitial nephritis as such is considered extremely rare. To the best of our knowledge, only 12 patients (including 7 case reports; Table 1 ) have been described in the English literature [ 2 , 7 – 13 ]. Remarkably, both our cases were diagnosed over the past year, suggesting that the incidence may have been underestimated.…”

Section: Discussionmentioning

confidence: 99%

“…[ 12 ] 17, M N 397 CS, AZA, anti-TNFα 813 1.5 Timmermans et al 19, M N 177 CS, CsA 133 1 22, F N 233 CS, FK506, MMF 186 1 Ulcerative colitis Alivanis et al . [ 13 ] 19, M Y 618 CS a 79 1 6-MP, 6-mercaptopurine; AZA, azathioprine; CS, corticosteroids; CsA, ciclosporine; ESRD, end-stage renal disease; FK506, tacrolimus; ND, not determined. a Cessation of 5-ASA after the diagnosis of granulomatous interstitial nephritis.…”

Section: Discussionmentioning

confidence: 99%

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Granulomatous interstitial nephritis and Crohn's disease

et al. 2016

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Granulomatous interstitial nephritis has been observed in <1% of native renal biopsies. Here, we describe two patients with granulomatous interstitial nephritis in relation to Crohn's disease. Circulating helper and cytotoxic T cells were highly activated, and both cell types predominated in the interstitial infiltrate, indicating a cellular autoimmune response. After immunosuppressive treatment, renal function either improved or stabilized in both patients. In conclusion, granulomatous interstitial nephritis is a genuine extraintestinal manifestation of Crohn's disease, the treatment of which should include immunosuppressive agents.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Granulomatous interstitial nephritis and Crohn's disease

et al. 2016

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“…Nephrotoxicity can be reversed if identified early on, with better recovery rates the earlier 5-ASA is discontinued. There are anecdotes of renal function recovery with steroids and a trial of high-dose steroids may be attempted if there is no improvement with drug withdrawal [54]. …”

Section: Safety Profilementioning

confidence: 99%

Mesalamine in the treatment and maintenance of remission of ulcerative colitis

Ham

Moss²

2012

Expert Review of Clinical Pharmacology

133

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Ulcerative colitis (UC) is a chronic disease of the GI tract that is characterized by mucosal inflammation in the colon. Mesalamine (mesalazine) is a 5-aminosalicylic acid compound that is the first-line treatment for patients with mild-to-moderate UC. There are multiple formulations of mesalamine available, primarily differentiated by their means of delivering active mesalamine to the colon. Mesalamine has been demonstrated in randomized controlled trials to induce both clinical response and remission, and maintain clinical remission, in these patients. It has few serious adverse effects and is generally well tolerated by patients. The main areas of uncertainty with use of mesalamine in patients with UC center on the optimal dose for induction of response, how to maintain patient adherence and the role of mesalamine in cancer chemoprophylaxis. Generic forms of mesalamine have yet to be approved by regulatory bodies in the USA.

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“…This adverse drug reaction is likely idiosyncratic. The clinical presentation is usually non-specific 1 2. There are no guidelines to recommend routine surveillance of renal function in IBD patients on mesalazine therapy.…”

Section: Descriptionmentioning

confidence: 99%