Primary IgA Vasculitis with Nephritis in a Patient with Rheumatoid Arthritis Diagnosed by Anti-galactose-deficient IgA1 Immunostaining

Karasawa, Kazunori; Iwabuchi, Yuko; Kyoda, Mizuki; Akihisa, Taro; Yamaguchi, Erika; Suzuki, Shunji; Ogura, Shota; Takabe, Tomo; Miyabe, Yoei; Kamiyama, Takahiro; Nakano, Marie; Manabe, Shun; Kamiyama, Michiaki; Akiyama, Kenichi; Sato, Masayo; Uchida, Keiko; Nitta, Kosaku; Moriyama, Takahito

doi:10.2169/internalmedicine.2640-19

Cited by 6 publications

(9 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In the present case, we performed a renal biopsy immediately after gross hematuria following a second mRNA-COVID-19 vaccination; the patient was diagnosed with IgAN. Furthermore, there is increasing evidence that IgA deposits in glomeruli in patients with primary IgAN are Gd-IgA1; this procedure involves staining kidney sections using monoclonal antibody against Gd-IgA1 (KM55) (11,12). In this case, Gd-IgA1 colocalized with IgA deposits, indicating that the present patient had gross hematuria due to the transient exacerbation of IgAN following mRNA vaccine BNT 162b2.…”

Section: Discussionmentioning

confidence: 86%

IgA Nephropathy with Gross Hematuria Following COVID-19 mRNA Vaccination

et al. 2022

View full text Add to dashboard Cite

A 28-year-old woman experienced gross hematuria after the administration of the second dose of an mRNA vaccine (BNT162b2). She was diagnosed with IgA nephropathy (IgAN) by a renal biopsy two weeks after vaccination, which revealed a mild increase in mesangial cells and a matrix with co-depositions of galactose-deficient IgA1 and C3 in the mesangial region. The gross hematuria and proteinuria gradually improved without any medication, suggesting that immune activation by the mRNA vaccine may not elicit continuous disease progression of IgAN. Thus, further studies investigating the relationship between mRNA vaccines against COVID-19 and the progression of IgAN should be conducted.

show abstract

Section: Discussionmentioning

confidence: 86%

IgA Nephropathy with Gross Hematuria Following COVID-19 mRNA Vaccination

et al. 2022

View full text Add to dashboard Cite

show abstract

“…In seven cases, all in patients treated with rituximab, IGD appeared within the first month of treatment, whereas in four cases (16.0%) IGDs had a long latency onset, and renal disorders developed after 2 years of treatment. Seven of the 25 patients were classified as affected by GNSV (Table 1 ) [ 18 – 22 ], seven as affected by IARD (Table 2 ) [ 23 – 28 ] and 11 as affected by GNLS (Table 3 ) [ 29 – 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patients treated with etanercept [ 18 , 19 ], secukinumab [ 20 ] and tofacitinib [ 21 ], and three patients treated with rituximab [ 22 ], developed GNSV, showing crescentic mesangial immunoglobulin A (IgA) deposits in the context of Schönlein–Henoch vasculitis (two cases, 28.6%) [ 18 , 21 ] or necrotizing crescentic glomerulonephritis with clinical and serological pictures of myeloperoxidase anti-neutrophil cytoplasmic antibodies (MPO-ANCA) vasculitis (two cases [28.6%]) [ 19 , 20 ], one of whom also presented mesangial IgA deposits [ 19 ]. Three patients affected by hepatitis C virus-related cryoglobulinemic vasculitis had a renal flare after rituximab treatment and presented deterioration of the known membrane-proliferative glomerulonephritis.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Biologics and Targeted Synthetic Drugs Can Induce Immune-Mediated Glomerular Disorders in Patients with Rheumatic Diseases: An Updated Systematic Literature Review

et al. 2021

View full text Add to dashboard Cite

Objective Our objective was to update the understanding of the development of paradoxical immune-mediated glomerular disorders (IGDs) in patients with rheumatic diseases treated with biologics and targeted synthetic drugs (ts-drugs). Methods A systematic literature review was performed by searching PubMed for articles published between 1 January 2014 and 1 January 2020 reporting on the development of IGD in adult patients with rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis or systemic lupus erythematosus (SLE) who were receiving biologics or ts-drugs. IGDs were classified on the basis of clinical, laboratory and histopathological data as (1) glomerulonephritis associated with systemic vasculitis (GNSV), (2) isolated autoimmune renal disorder (IARD) or (3) glomerulonephritis in SLE and in lupus-like syndrome (GNLS). The World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system for standardized case causality assessment was applied to evaluate the causal relationship between IGD and specific drugs. The classification was based on a six-category scale, where the “certain” and “probable” categories were deemed clinically relevant relationships. Results The literature search retrieved 875 articles. Of these, 16 articles reported IGD data, for a total of 25 cases. According to the WHO-UMC assessment, the strength of the causal relationship between IGDs and investigated drugs was higher for anti-tumor necrosis factor-α agents (a clinically relevant relationship was found in four of six cases), abatacept (one of two cases), tocilizumab (two cases), ustekinumab (one case) and tofacitinib (one case) than for rituximab (nine cases), belimumab (three cases) or secukinumab (one case), which showed a weak causal relationship with these paradoxical events. No cases associated with apremilast or baricitinib were found. The retrieved cases were classified as 11 GNLS, seven IARD and seven GNSV. Conclusions Biologics and ts-drugs can cause IGDs. These events are rare, and the causative effect of a specific drug is hard to establish. When a patient is suspected of having an IGD, the drug should be discontinued, and treatment for the new-onset renal disorder should be promptly started.

show abstract

“…Purpura nephritis, also called Henoch-Schönlein purpura nephritis, is a systemic disease with small dead vasculitis as the main pathological change[ 1 - 3 ]. Clinical studies have suggested that the disease is caused by stimuli such as parasitic infections and drug or food allergies[ 4 , 5 ], and epidemiological analysis has shown that the incidence of the disease has increased in recent years[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

Li¹,

Huang²,

Zhang³

et al. 2020

WJCC

View full text Add to dashboard Cite

BACKGROUND Purpura nephritis, also called Henoch-Schönlein purpura nephritis, is a systemic disease with small dead vasculitis as the main pathological change. AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis. METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group (41 children) and transitional nursing group (41 children) using the envelope method. The general nursing group received routine nursing care, while the transitional nursing group received transitional nursing care. The behaviors, knowledge of the disease, and self-management ability of the two groups were evaluated after nursing care was provided. RESULTS The scores of four items (self-care ability, self-responsibility, health knowledge level, and self-concept) in the transitional nursing group were significantly higher than those in the general nursing group. CONCLUSION Transitional nursing can directly improve the disease knowledge level and self-management ability of children with purpura nephritis and effectively reduce complications.

show abstract

Primary IgA Vasculitis with Nephritis in a Patient with Rheumatoid Arthritis Diagnosed by Anti-galactose-deficient IgA1 Immunostaining

Cited by 6 publications

References 17 publications

IgA Nephropathy with Gross Hematuria Following COVID-19 mRNA Vaccination

IgA Nephropathy with Gross Hematuria Following COVID-19 mRNA Vaccination

Biologics and Targeted Synthetic Drugs Can Induce Immune-Mediated Glomerular Disorders in Patients with Rheumatic Diseases: An Updated Systematic Literature Review

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

Contact Info

Product

Resources

About