Successful treatment of HIV‐associated lupus‐like glomerulonephritis with mycophenolic acid

Tiong, Mark K; Wilson, Scott G.; Pham, Alan; Chrysostomou, Anastasia

doi:10.1002/ccr3.2955

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…These circulating immune complexes trigger immune-mediated inflammatory kidney injury, which explains, in part, why HIV-associated glomerulonephritis shares similar histopathologic lesions with LN. These observations led Tiong et al to suggest that patients with HIV-associated lupus-like nephritis may respond to therapies traditionally used in primary LN, which is why they were the first to use MPAA [ 13 ]. In line with the above, Kalyan et al described the use of rituximab in an HIV patient with lupus-like membranous nephropathy who achieved partial remission [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Glucocorticoids have been used in patients with HIVAN with a favourable outcome [ 9 , 10 , 11 , 12 ]; however, data about immunosuppression therapy in HIVICK are limited. The use of HAART alone or in combination with immunosuppressive agents including mycophenolic acid analogues (MPAA) and glucocorticoids has been described in several cases with controversial results [ 13 , 14 ]. Furthermore, applying immunosuppressive therapy in already immunocompromised subjects raises concerns.…”

Section: Introductionmentioning

confidence: 99%

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Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Kofotolios

Tsiakas

Skalioti

et al. 2023

Life

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Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and immunofluorescence. Management of HIVICK remains controversial and mainly focuses on HIV viremia suppression with combined antiretroviral therapy. Immunosuppressive therapy may be used in order to mitigate the renal inflammation induced by the immune complex deposition. Data regarding the use of immunosuppressants in HIVICK are very limited, mostly including corticosteroids and mycophenolate acid analogues. Herein, we present the case of a 40-year-old HIV-infected Caucasian man with nephrotic syndrome, renal impairment, and a “lupus-like” membranous pattern in the kidney biopsy, who achieved a partial response of his proteinuria with a tacrolimus-based regimen in combination with antiretroviral therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Kofotolios

Tsiakas

Skalioti

et al. 2023

Life

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“…HIVK results from the deposition of immune complexes in the glomerulus and from tissue damage, but the mechanism by which this occurs is not well known: circulating immune complexes can remain trapped in the glomerulus, or immune complexes can be formed in situ. Several HIVICK-associated glomerulopathies have been described in the literature, including lupus-like glomerulonephritis, HIV-associated IgA nephropathy, and HIV-associated membranous nephropathy [ 62 , 63 , 64 , 65 ]. ANCA antibodies (AAV-associated) and anti-GBM antibodies (anti-GBM disease-associated) have been found in HIV-infected patients without any renal disease, raising the suspicion that the formation of autoantibodies in HIV may not always be pathogenic [ 66 , 67 , 68 , 69 ].…”

Section: Viral Infections and Glomerulonephritismentioning

confidence: 99%

Autoimmunity and Infection in Glomerular Disease

Casuscelli,

Longhitano,

Maressa

et al. 2023

Microorganisms

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The ongoing glomerular damage of infections is not limited to the most widely known form of post-streptococcal glomerulonephritis, which is today less common in the Western world; other forms of glomerulonephritis are associated with several bacterial, viral and parasitic pathogens. The mechanisms responsible range from the direct damage of glomerular cells to the formation and deposition of immunocomplexes to molecular mimicry to the secretion of superantigens. Similarly, in the course of glomerular disease, infections are more frequent than in the general population due to the loss of immunoglobulins in urine and the immunosuppressive agents used to treat the autoimmune disease that decrease the activity of the immune system. Recognizing this two-way link, understanding its pathogenetic mechanism, and identifying the most appropriate therapeutic choice are essential for the personalized management of patients. In this continuously developing field, this short review summarizes the current state of the art as support for physicians, who are increasingly involved in managing patients with glomerular disease and infections.

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Renal Autoimmunity: The Role of Bacterial and Viral Infections – An Extensive Review

Lavine,

Ohayon,

Mahroum

2024

Infection and Autoimmunity

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Successful treatment of HIV‐associated lupus‐like glomerulonephritis with mycophenolic acid

Cited by 5 publications

References 23 publications

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature

Autoimmunity and Infection in Glomerular Disease

Renal Autoimmunity: The Role of Bacterial and Viral Infections – An Extensive Review

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