scholarly journals The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Vedran Premužić ◽  
Ivan Padjen ◽  
Mislav Cerovec ◽  
Marijana Ćorić ◽  
Bojan Jelaković ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Diabetes Mellitus ◽  
Iga Nephropathy ◽  
Tnf Alpha ◽  
Prior History ◽  
Macroscopic Hematuria ◽  
The Third ◽  
Stage Renal Disease ◽  
End Stage ◽  
Alpha Therapy

IgA nephropathy (IgAN) is a rather uncommon complication of TNF-alpha inhibition with a range of findings such as asymptomatic microscopic/macroscopic hematuria or different degrees of proteinuria and could progress to end-stage renal disease. We are reporting three patients with longstanding rheumatoid arthritis (RA), which developed IgAN while receiving TNF-alpha inhibitors. All off our three patients had RA, which lasted 2–4 years, and none of them had a prior history of chronic kidney disease. Two patients were treated with adalimumab while one patient was treated with golimumab. Discontinuation of anti-TNF-alpha therapy and initiation of immunosuppressive therapy led to improvement in serologic abnormalities and renal function in two patients, while the third patient’s 24-hour proteinuria was only partially reduced, which supports previous reports on TNF-alpha inhibitor induced autoimmunity. Two of our patients had previously been diagnosed with type 2 diabetes mellitus while the third patient developed diabetes years after the onset of IgAN. This is in line with the previously described association of IgAN and diabetes mellitus. To our best knowledge, this is the first report to analyze the development of IgAN as a potential consequence of anti-TNF-alpha therapy and its possible association with pretreatment or posttreatment diabetes.

scholarly journals P0488IG A NEPHROPATHY: ANALYSIS OF 501 BIOPSY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marwa Omrane ◽  
Raja Aoudia ◽  
Mondher Ounissi ◽  
Soumaya Chargui ◽  
Mouna Jerbi ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Vascular Lesions ◽  
Macroscopic Hematuria ◽  
Systematic Screening ◽  
Female Ratio ◽  
Male Predominance ◽  
Glomerular Lesions ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Mesangial deposits Ig A was described the first time in 1968 by Berger and Hinglais. It remains the most common primary glomerulonephritis worldwide. It is often idiopathic but can also be secondary. The aim of our study is to describe the epidemiologic characteristics, the incidence and the anatomopathological features of 501 IgA nephropathy (IgA N) patients. Method It is a retrospective mono-centric study including patients having IgA N in the renal biopsy done in our department among a period of 17 years. Results We analyzed data of 8427 patients who underwent renal biopsy. 81% had glomerular nephropathy with 7.3% (501) IgA N. A male-to-female ratio of 2.27. The average age was 28.7 years. IgA N was primary in 80.2% cases and secondary in 17.8% cases. The most frequent secondary IgA N was rheumatoid purpura (74.8%). There was a male predominance in Berger‘s disease as well as in rheumatoid purpura. Berger’s disease was more common in adults, whereas rheumatoid purpura was more common in children. The main indication of renal biopsy was proteinuria with hematuria in 23.2% of cases and nephrotic syndrome in 23.8%. The association of non-nephrotic proteinuria, hematuria, arterial hypertension and renal injury was found in 9.3% whereas isolated macroscopic hematuria only in 6.4% of cases. According to HAAS classification, HAAS 3 was the most frequent. OXFORD classification used only from 2010, and M1, S1, E0, T0 and M1, S1, E0, T2 were the most frequent. Glomerular lesions were associated to tubulo interstitial and vascular lesions in 48.2% of cases. Conclusion IgA nephropathy is the most common glomerular disease and a frequent cause of end stage renal disease. Because of a clear increase of it’s incidence in our country and the delay in the diagnosis, a systematic screening of urines is needed in our country as it’s done in Singapore and Japan.

scholarly journals Low Birth Weight and Risk of Progression to End Stage Renal Disease in IgA Nephropathy—A Retrospective Registry-Based Cohort Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. e0153819 ◽  
Author(s):  
Paschal Ruggajo ◽  
Einar Svarstad ◽  
Sabine Leh ◽  
Hans-Peter Marti ◽  
Anna Varberg Reisæther ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Renal Disease ◽  
Iga Nephropathy ◽  
End Stage Renal Disease ◽  
Risk Of Progression ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals AB0234 ASSOCIATION OF HOMOCYSTEINE LEVEL AND CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1417.3-1417
Author(s):  
D. Anghel ◽  
L. Otlocan ◽  
R. Bursuc ◽  
E. Busuioc ◽  
A. Manolache ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Homocysteine Level ◽  
Intima Media Thickness ◽  
Antiplatelet Agents ◽  
Carotid Intima Media Thickness ◽  
Tnf Alpha ◽  
Das28 Score ◽  
Media Thickness ◽  
Alpha Therapy

Background:Homocysteine (Hcy) has been implicated in atherogenesis. High homocysteine level can predict cardiovascular events, including death. Atherosclerosis has a high incidence in patients with Rheumatoid Arthritis (RA).Objectives:The aim of this study is to evaluate the relationship between serum homocysteine levels and carotid atherosclerosis in patients with RA and anti-TNF therapy.Methods:Our study included 80 RA patients divided into two groups: 45 patients were with anti-TNF-alpha therapy (Adalimumab, Infliximab, Etanercept) and 35 RA patients with disease-modifying antirheumatic drugs (DMARDs). The patients were diagnosed with RA used ACR/EULAR 2010 Classification Criteria. We measured carotid intima-media thickness (CIMT) using high-resolution Doppler ultrasonography at baseline and then at 12 months. CIMT above 0.9 mm is an atherosclerosis marker. We considered high levels of homocysteine in the serum above 15 µmol/L. All patients had treatment with hypolipemiant drugs and antiplatelet agents during the 12 months. Other parameters were analyzed at baseline and after 12 months: age, lipid profile (HDL, LDL, and cholesterol), ESR and disease activity score (DAS28<2.6 means remission; DAS28=2.6-3.2 means low disease activity, DAS28=3.2-5.1 means moderate disease activity; DAS28>5.1 high disease activity).Results:45 patients received anti-TNF-alpha therapy (mean age 45.50±9.69 years) and 35 RA patients had treatment with DMARDs (mean age 48.3±8.9 years). High Hcy levels were found on 34% patients in DMARDs group and 21% patients in anti-TNF group. After 12 months of treatment, patients with high levels of Hcy and anti-TNF therapy had a significant decrease in CIMT. In patients with low Hcy level the decrease in CIMT was insignificantly statistic. In DMARDs group atherosclerotic plaque was detected to 26 patients (74.29%) and 21 (46.66%) patients were detected into anti-TNF group. After 12 months CIMT was significantly higher in DMARDs group and the difference was statistically significant compared to baseline and to anti-TNF group (p=0.0002). High DAS28 score was associated with increased CIMT and hyperhomocysteinemia in both groups (p=0.0001).Conclusion:Increased Hcy levels were associated with increased CIMT values in both groups. In RA patients with anti-TNF therapy and high Hcy levels, reduction of CIMT was statistically higher than in patients with DMARDs treatment.Disclosure of Interests:None declared

Sign in / Sign up

Export Citation Format

Share Document