Development of the nephrotic syndrome during treatment of Crohn's disease with adalimumab

We report a patient with Crohn's disease who presented with renal insufficiency and the nephrotic syndrome after initiating therapy with adalimumab. Renal biopsy showed stages 2 to 3 membranous glomerulonephritis, and immunostaining showed glomerular deposition of immunoglobulin G and C3. The p...

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Vydáno v:Journal of clinical gastroenterology Ročník 45; číslo 3; s. e30
Hlavní autoři: Gupta, Alok, Pendyala, Prashant, Arora, Pradeep, Sitrin, Michael D
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.03.2011
Témata:
Adalimumab
Anti-Inflammatory Agents - adverse effects
Anti-Inflammatory Agents - therapeutic use
Antibodies, Monoclonal - adverse effects
Antibodies, Monoclonal - therapeutic use
Antibodies, Monoclonal, Humanized
Crohn Disease - complications
Crohn Disease - drug therapy
Humans
Male
Middle Aged
Nephrotic Syndrome - chemically induced
Nephrotic Syndrome - physiopathology
ISSN:1539-2031, 1539-2031
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Shrnutí:We report a patient with Crohn's disease who presented with renal insufficiency and the nephrotic syndrome after initiating therapy with adalimumab. Renal biopsy showed stages 2 to 3 membranous glomerulonephritis, and immunostaining showed glomerular deposition of immunoglobulin G and C3. The patient's serum creatinine decreased after discontinuation of adalimumab, and treatment with prednisone and mycophenolic acid reversed his proteinuria. The pathogenesis of glomerular disease induced by antitumor necrosis factor antibodies is uncertain, and the potential roles of the generation of autoantibodies, development of antiadalimumab antibodies, and the interaction of adalimumab with glomerular tumor necrosis factor are discussed.
Bibliografie:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:1539-2031
1539-2031
DOI:10.1097/MCG.0b013e3181fae913