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Review
. 2021 Mar 17:15:61-66.
doi: 10.2147/BTT.S297712. eCollection 2021.

Glomerulonephritis in Two Patients with SpA Treated with TNF-α Blockers and a Review of the Literature

Constantina A Bounia  1 , Eftichia N Theodoropoulou  1 , Stamatic-Nick C Liossis  1   2
Affiliations
Review

Glomerulonephritis in Two Patients with SpA Treated with TNF-α Blockers and a Review of the Literature

Constantina A Bounia et al. Biologics. .

Abstract

Renal failure or acute/chronic kidney damage may present as a clinical manifestation of rheumatic diseases. In addition treatment with DMARDs or biologic drugs may induce nephrotoxicity. In this case-based review, we present two patients with SpA under anti-TNF-α treatment admitted to our hospital because of renal failure and proteinuria. We review previously published yet isolated cases of TNF-α blocker-induced glomerular disease in patients with SpA. Renal manifestations are occasionally seen in patients with ankylosing spondylitis and psoriatic arthritis with IgA nephropathy being the most common of them. Anti-TNF-α agents although reportedly used for the treatment of glomerular nephropathy as a disease manifestation, they have been considered responsible for provoking renal damage in some cases. A diagnostic approach for patients with SpA treated with anti-TNF-α agents presenting with renal manifestations is proposed herein.

Keywords: anti-TNF-alpha agents; glomerular disease; kidney biopsy; proteinuria; spondylarthritides.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
A proposed decision tree on the approach of the patient with SpA and renal involvement.
See this image and copyright information in PMC

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