Development of myeloperoxidase-antineutrophil cytoplasmic antibody-associated renal vasculitis in a patient receiving treatment with anti-tumor necrosis factor-α.
We report on a 33-year-old woman who presented with positive myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) during rheumatoid arthritis treatment with infliximab. She had a history of worsening arthralgia, and urinalysis showed the new occurrence of hematuria and proteinuria. Renal biopsy showed necrotizing crescentic glomerulonephritis. Immunosuppressive therapy and discontinuation of the infliximab therapy alleviated her arthralgia and improved the urinalysis results. We report this rare case in which an anti-tumor necrosis factor-α (TNF-α) agent for ANCA-associated systemic vasculitis was studied.
Hirohama
Daigoro
D
Kidney Center, Toranomon Hospital, 2-2-2 Toranomon, Minato Ward, Tokyo, 105-8470, Japan. daigoro-daigoro@hotmail.co.jp
Hoshino
Junichi
J
Hasegawa
Eiko
E
Yamanouchi
Masayuki
M
Hayami
Noriko
N
Suwabe
Tatsuya
T
Sawa
Naoki
N
Takemoto
Fumi
F
Ubara
Yoshifumi
Y
Hara
Shigeko
S
Ohashi
Kenichi
K
Takaichi
Kenmei
K
D000284:Administration, Oral; D000328:Adult; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D057915:Drug Substitution; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D000069285:Infliximab; D007275:Injections, Intravenous; D007668:Kidney / Q000098:blood supply / Q000187:drug effects / Q000276:immunology; D007674:Kidney Diseases / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D008775:Methylprednisolone / Q000627:therapeutic use; D009195:Peroxidase / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*; D014657:Vasculitis / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology
D019268:Antibodies, Antineutrophil Cytoplasmic; D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D005938:Glucocorticoids; D014409:Tumor Necrosis Factor-alpha; D011239:Prednisolone; D000069285:Infliximab; D009195:Peroxidase; D008775:Methylprednisolone