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

Authors Bounia CA, Theodoropoulou EN, Liossis SNC

Received 22 December 2020

Accepted for publication 16 February 2021

Published 17 March 2021 Volume 2021:15 Pages 61—66


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Doris Benbrook

Constantina A Bounia,1 Eftichia N Theodoropoulou,1 Stamatic-Nick C Liossis1,2

1Division of Rheumatology, Patras University Hospital, Patras, Greece; 2Department of Internal Medicine, University of Patras Medical School, Patras, Greece

Correspondence: Stamatic-Nick C Liossis
Div. of Rheumatology, Patras University Hospital, GR 26500, Rion, Patras, Greece
Tel +30 2613 603 693
Fax +30 2610 993 982
Email [email protected]

Abstract: 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.

Keywords: spondylarthritides, glomerular disease, proteinuria, kidney biopsy, anti-TNF-alpha agents

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