Cargando…

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...

Descripción completa

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:
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
_version_ 1784878222746320896
author 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
author_facet 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
author_sort Fukuda, Makoto
collection PubMed
description 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.
format Online
Article
Text
id pubmed-9876708
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher The Japanese Society of Internal Medicine
record_format MEDLINE/PubMed
spelling pubmed-98767082023-02-02 Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis 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 Intern Med Case Report 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. The Japanese Society of Internal Medicine 2022-05-31 2023-01-01 /pmc/articles/PMC9876708/ /pubmed/35650123 http://dx.doi.org/10.2169/internalmedicine.9059-21 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
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
Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title_full Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title_fullStr Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title_full_unstemmed Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title_short Endothelial Damage-dominant Nephritis Related to IgA Vasculitis after 11 Years' Use of Infliximab for Rheumatoid Arthritis
title_sort endothelial damage-dominant nephritis related to iga vasculitis after 11 years' use of infliximab for rheumatoid arthritis
topic Case Report
url 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
work_keys_str_mv AT fukudamakoto endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT sawanaoki endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT ikumadaisuke endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT obayuki endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT mizunohiroki endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT yamanouchimasayuki endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT sekineakinari endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT hasegawaeiko endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT suwabetatsuya endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT hoshinojunichi endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT konokei endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT kinowakikeiichi endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT ohashikenichi endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT tamakihiromichi endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT miyazonomotoaki endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis
AT ubarayoshifumi endothelialdamagedominantnephritisrelatedtoigavasculitisafter11yearsuseofinfliximabforrheumatoidarthritis