title: Complete Remission of Nephrotic Syndrome Without Resolution of Amyloid Deposit After Anti-Tumor Necrosis Factor α Therapy in a Patient With Ankylosing Spondylitis.
abstract: In secondary amyloid A amyloidosis resulting from rheumatologic diseases, tumor necrosis factor α blockers have been reported to be effective in the treatment of both arthritis and amyloidosis. However, there have been few reports concerning the alterations of renal tissue histology before and after long-term tumor necrosis factor α blockers therapy in secondary renal amyloidosis. We report the histological change after tumor necrosis factor α blocker therapy in patient with amyloid A amyloidosis and nephrotic syndrome secondary to underlying ankylosing spondylitis. The patient achieved complete remission of nephrotic syndrome after 17 months of etanercept treatment. We performed the second kidney biopsy after 40 months, and there was little change in the degree of amyloid deposition in the mesangial area and capillary loops compared with the first biopsy. The interstitial inflammation and foot process effacement, however, were fully recovered.
authors.affiliation: From the *Division of Nephrology, and †Division of Rheumatology, Department of Internal Medicine, and ‡Department of Pathology, Kyung Hee University, College of Medicine, Seoul, Korea.
authors.forename: Yu Ho
authors.initials: YH
authors.lastname: Lee
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Kim
authors.forename: Da Wun
authors.initials: DW
authors.lastname: Jeong
authors.forename: Yang-Gyun
authors.initials: YG
authors.lastname: Kim
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Ran
authors.initials: R
authors.lastname: Song
authors.forename: Hyung In
authors.initials: HI
authors.lastname: Yang
authors.forename: Sung Jig
authors.initials: SJ
authors.lastname: Lim
authors.forename: Ju-Young
authors.initials: JY
authors.lastname: Moon
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000686:Amyloidosis / Q000150:complications / Q000188:drug therapy*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D009404:Nephrotic Syndrome / Q000150:complications / Q000188:drug therapy*; D058225:Plaque, Amyloid; D012074:Remission Induction; D013167:Spondylitis, Ankylosing / Q000150:complications*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068800:Etanercept