IgA nephropathy in a patient with ankylosing spondylitis well controlled with etanercept

Abstract

Ankylosing spondylitis (AS) can involve the eye, gastrointestinal system, cardiopulmonary system, skin, kidneys, and spinal and peripheral joints. It is rarely accompanied by immunoglobulin A (IgA) nephropathy. Although IgA is involved in both AS and IgA nephropathy, the relationship between these diseases remains unclear. We detected hematuria and proteinuria in a 32-year-old male patient with ankylosing spondylitis that remained stable for 4 years through treatment with etanercept, a tumor necrosis factor-α (TNF-α) inhibitor, and diagnosed IgA nephropathy through a renal biopsy. IgA nephropathy seems to be less commonly associated with AS disease activity or specific treatment such as TNF-α inhibitor use.

IgA Nephropathy—Ankylosing Spondylitis–Associated or Adalimumab-Induced?

“…1,8 Some studies have reported clinical cases in which the development of IgA nephropathy seems to be associated with the use of TNFi. 4,[9][10][11][12] In fact, 3 previous cases reported IgA nephropathy in AS patients treated with infliximab or etanercept. [10][11][12] Our case is the first report with an AS patient treated with adalimumab who develop IgA nephropathy and in whom it was necessary to discontinue the TNFi.…”

“…4,[9][10][11][12] In fact, 3 previous cases reported IgA nephropathy in AS patients treated with infliximab or etanercept. [10][11][12] Our case is the first report with an AS patient treated with adalimumab who develop IgA nephropathy and in whom it was necessary to discontinue the TNFi. Despite, other studies have already reported IgA nephropathy associated with adalimumab, but in patients with other immunologic diseases.…”

“…Some studies have reported clinical cases in which the development of IgA nephropathy seems to be associated with the use of TNFi 4,9–12 . In fact, 3 previous cases reported IgA nephropathy in AS patients treated with infliximab or etanercept 10–12 .…”