Rheumatology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
Department of Nephrology, CHR Mons-Hainaut, Mons, Hainaut, Belgium.
BMJ Case Rep. 2021 Jan 29;14(1):e237713. doi: 10.1136/bcr-2020-237713.
We report the case of a 43-year-old man, suffering from ankylosing spondylitis and treated with Infliximab 5 mg/kg every 2 months, with an excellent disease control. During a follow-up consultation, an incipient renal insufficiency is detected. A urine analysis showed haematuria and proteinuria and a renal puncture-biopsy revealed an image of IgA nephropathy.Several cases of IgA nephropathy have been reported in the literature associated with ankylosing spondylitis. Some of them occur in patients treated with antitumour necrosis factor, but it is unclear whether this pathology is caused by the treatment or whether treatment failed to prevent its occurrence.Our clinical case highlights the importance of regular monitoring of renal function in patients with ankylosing spondylitis, as well as urinary spotting.The question of whether the disease itself, the treatment or other factors such as immune dysregulation could be held responsible for kidney disease will be addressed in the discussion.
我们报告了一例 43 岁男性病例，患有强直性脊柱炎，接受英夫利昔单抗 5mg/kg 每 2 个月治疗，疾病控制良好。在随访咨询时，发现肾功能初始不全。尿液分析显示血尿和蛋白尿，肾穿刺活检显示 IgA 肾病的图像。文献中有几例与强直性脊柱炎相关的 IgA 肾病报道。其中一些发生在接受抗肿瘤坏死因子治疗的患者中，但尚不清楚这种病理学是由治疗引起的，还是治疗未能预防其发生。我们的临床病例强调了定期监测强直性脊柱炎患者肾功能以及尿潜血的重要性。疾病本身、治疗或其他因素，如免疫失调，是否应对肾脏疾病负责，将在讨论中讨论。
