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Onset of IgA nephropathy in a patient treated with infliximab for ankylosing spondylitis
  1. Charlotte Anne Baert1,
  2. Selda Aydin1,
  3. Philippe Leroy2 and
  4. Patrick Durez1
  1. 1Rheumatology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium
  2. 2Department of Nephrology, CHR Mons-Hainaut, Mons, Hainaut, Belgium
  1. Correspondence to Professor Patrick Durez; patrick.durez{at}uclouvain.be

Abstract

We report the case of a 43-year-old man, suffering from ankylosing spondylitis and treated with Infliximab 5 mg/kg every 2 months, with an excellent disease control. During a follow-up consultation, an incipient renal insufficiency is detected. A urine analysis showed haematuria and proteinuria and a renal puncture-biopsy revealed an image of IgA nephropathy.

Several cases of IgA nephropathy have been reported in the literature associated with ankylosing spondylitis. Some of them occur in patients treated with antitumour necrosis factor, but it is unclear whether this pathology is caused by the treatment or whether treatment failed to prevent its occurrence.

Our clinical case highlights the importance of regular monitoring of renal function in patients with ankylosing spondylitis, as well as urinary spotting.

The question of whether the disease itself, the treatment or other factors such as immune dysregulation could be held responsible for kidney disease will be addressed in the discussion.

  • anklosing spondylitis
  • biological agents

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Footnotes

  • Contributors CAB: data collection; data analysis and interpretation; design of the article; critical review and final draft approval; accountable for accuracy and integrity. SA: data collection; data analysis and interpretation; design of the article; critical review and final draft approval; accountable for accuracy and integrity. PL: design of the article; data analysis and interpretation; critical review and final draft approval; accountable for accuracy and integrity. PD: conception and design of the article; data analysis and interpretation; critical review and final draft approval; accountable for accuracy and integrity

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.