title: Permanent renal loss following tumor necrosis factor α antagonists for arthritis.
abstract: Tumor necrosis factor alpha (TNF-alpha) antagonists are now widely used in the treatment of aggressive rheumatoid arthritis and are generally well tolerated. Although rare, they could induce systemic lupus erythematosus, glomerulonephritis, and antineutrophil cytoplasmic antibody associated systemic vasculitis. Tumor necrosis factor alpha antagonists associated glomerulonephritis usually subsides after discontinuation of the therapy and subsequent initiation of corticosteroids and immunosuppressive agents. Here we describe crescentic glomerulonephritis progression to end-stage renal disease in a patient following two doses of TNF-alpha antagonists for the treatment of reactive arthritis. To our knowledge, dialysis dependent permanent renal loss after TNF-alpha antagonists has not yet been reported. We suggest the renal function should be closely monitored in patients treated with TNF-alpha antagonists by rheumatologists.
authors.affiliation: Department of Nephrology and Kidney Institute, China Medical University Hospital, No 2 Yuh-Der Rd, Taichung 404, Taiwan.
authors.forename: Tzu-Jen
authors.initials: TJ
authors.lastname: Chen
authors.forename: Ya-Fei
authors.initials: YF
authors.lastname: Yang
authors.forename: Po-Hao
authors.initials: PH
authors.lastname: Huang
authors.forename: Hsin-Hung
authors.initials: HH
authors.lastname: Lin
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000150:complications / Q000188:drug therapy*; D018450:Disease Progression; D005921:Glomerulonephritis / Q000139:chemically induced; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced*; D007677:Kidney Function Tests; D008297:Male; D006435:Renal Dialysis; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab