Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis

A 43-year-old Japanese woman with rheumatoid arthritis treated by infliximab and methotrexate for 11 years was admitted for proteinuria and purpura. A kidney biopsy revealed endothelial damage-dominant nephritis with IgA deposition. Infliximab and methotrexate were discontinued, and tocilizumab was...

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Detalles Bibliográficos
Autores principales: Fukuda, Makoto, Sawa, Naoki, Ikuma, Daisuke, Oba, Yuki, Mizuno, Hiroki, Yamanouchi, Masayuki, Sekine, Akinari, Hasegawa, Eiko, Suwabe, Tatsuya, Hoshino, Junichi, Kono, Kei, Kinowaki, Keiichi, Ohashi, Kenichi, Tamaki, Hiromichi, Miyazono, Motoaki, Ubara, Yoshifumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9876708/
https://www.ncbi.nlm.nih.gov/pubmed/35650123
http://dx.doi.org/10.2169/internalmedicine.9059-21
Descripción
Sumario:A 43-year-old Japanese woman with rheumatoid arthritis treated by infliximab and methotrexate for 11 years was admitted for proteinuria and purpura. A kidney biopsy revealed endothelial damage-dominant nephritis with IgA deposition. Infliximab and methotrexate were discontinued, and tocilizumab was started; however, proteinuria persisted. Therefore, tocilizumab was discontinued, and oral prednisolone and methylprednisolone pulse therapy were administered. After 6 months, urinary protein was less than 0.1 g/day, and purpura subsided. To our knowledge, this is the first case of endothelial damage-dominant nephritis related to IgA vasculitis involving the skin and kidney after long-term use of infliximab and methotrexate.

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