Case Report
The Association of TNF-Alpha Inhibitors and Development of IgA Nephropathy in Patients with Rheumatoid Arthritis and Diabetes
Table 1
Clinical characteristics of three RA patients with IgA glomerulonephritis following anti-TNF-α therapy.
| | | Case 1 | Case 2 | Case 3 |
| | Months from first visit to diagnosis of RA | 22 | 24 | 57 | | Steroids in months | 22 | 5 | 51 | | Methotrexate in months | 3 | 36 | 23 | | Prior diabetes | No | Yes | Yes | | Prior arterial hypertension | No | No | No |
| | Months from diagnosis of RA to introduction of biologic treatment | 48 | 34 | 27 | | DAS28 at biologic treatment introduction | 5.52 | 6.30 | 7.09 | | DAS28 after biologic treatment introduction | 2.66 | 2.09 | 2.28 | | TNF-α inhibitor | Adalimumab | Golimumab | Adalimumab |
| | Months from introduction of biologic treatment to kidney biopsy | 59 | 36 | 70 | | Peripheral oedema | No | Yes | Yes | | 24 h urine proteinuria (g/dU) | 2.25 | 0.47 | 4.55 | | Erithrocyturia | Yes | No | No | | Serum creatinine (μmol/L) | 137 | 61 | 81 | | eGFR (mL/min/1.73 m2) | 54.8 | 112.8 | 68.0 | | Blood pressure (mmHg) | 175/94 | 160/90 | 170/90 | | Arterial hypertension | Yes | Yes | Yes | | Hemoglobin (g/dl) | 13.1 | 11.7 | 10.5 | | White blood cell count (×109/L) | 7.8 | 7.1 | 13.3 | | Cholesterol (mmol/L) | 5.7 | 4.6 | 5.6 | | Triglycerides (mmol/L) | 2.78 | 0.61 | 1.65 | | Erythrocyte sedimentation rate (mm/h) | 64 | 20 | 100 | | C-reactive protein (mg/L) | 18.3 | 1.7 | 45.9 |
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RA-rheumatoid arthritis; eGFR-estimated glomerular filtration rate.
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