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Case Reports
. 2019 Aug 18;11(8):e5419.
doi: 10.7759/cureus.5419.

Etanercept-associated Nephropathy

Awais Ammar  1 , Hafiz Zafar Ahmed Mahmood  1 , Zainab Shahid  2 , Rohit Jain  1 , Guoli Chen  3
Affiliations
Case Reports

Etanercept-associated Nephropathy

Awais Ammar et al. Cureus. .

Abstract

Anti-TNF (tumor necrosis factor) medications work by inhibiting the production of TNF or its effect on target organs. TNF is a cell-signaling protein, or cytokine, involved in systemic inflammation and is one of the cytokines that make up the acute phase reactants. TNF inhibitors are available for the treatment of a number of rheumatic and other immune-mediated diseases. Treatment of rheumatoid arthritis with anti-TNFα (tumor necrosis factor-alpha) agents may lead to autoantibody formation and flares of vasculitis. Although medications are a common cause of renal injury, anti-TNFα medications very rarely cause renal complications. We present a case of a patient who presented with nausea and flu-like illness and was ultimately found to have etanercept-induced nephropathy.

Keywords: acute kidney injury; anti tnf; anti-tnf therapy; etanercept; glomerulo nephritis; rheumatoid arthritis; tnf inhibitor; tnf-tumor necrosis factor; tumor necrosis factor alpha (tnf alpha).

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Light Microscopy
Light microscopy depicting moderate interstitial fibrosis with associated tubular atrophy and chronic inflammation.
Figure 2
Figure 2. Immunofluorescence
Immunofluorescence depicting granular staining of IgG (3+), IgA (2+), IgM (2+), and C3 (2+) in the glomerular walls and mesangium. IgG: Immunoglobulin G; IgM: Immunoglobulin M; IgA: Immunoglobulin A; C3: Complement component 3.
Figure 3
Figure 3. Electron Microscopy
Electron microscopy depicting scattered electron densities predominantly in the intramembranous and mesangial areas (black arrow).
Figure 4
Figure 4. Electron Microscopy
Electron microscopy depicting scattered electron densities predominantly in the intramembranous and mesangial areas (black arrows).
Figure 5
Figure 5. Creatinine Trend
Creatinine trend after withdrawing etanercept and beginning treatment with mycophenolate mofetil and steroids.
See this image and copyright information in PMC

References

    1. Tumor necrosis factor-α signaling in macrophages. Parameswaran N, Patial S. Crit Rev Eukaryot Gene Expr. 2010;20:87–103. - PMC - PubMed
    1. Enbrel (etanercept) [Jul;2019 ];https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/103795s5556lbl... 1998
    1. Life-threatening hypercalcemia and acute kidney injury induced by etanercept. Tsevi YM, Aydin S, Durez P, Labriola L. Nephrol Ther. 2018;14:478–482. - PubMed
    1. Acute kidney injury due to renal sarcoidosis during etanercept therapy: a case report and literature review. Akiyama M, Kaneko Y, Hanaoka H, Kuwana M, Takeuchi T. Intern Med. 2015;54:1131–1134. - PubMed
    1. Membranous glomerulonephritis with the use of etanercept in ankylosing spondylitis. Kaushik P, Rahmani M, Ellison W. Ann Pharmacother. 2011;45:1585. - PubMed

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