Bounia Constantina A, Theodoropoulou Eftichia N, Liossis Stamatic-Nick C
Division of Rheumatology, Patras University Hospital, Patras, Greece.
Department of Internal Medicine, University of Patras Medical School, Patras, Greece.
Biologics. 2021 Mar 17;15:61-66. doi: 10.2147/BTT.S297712. eCollection 2021.
Renal failure or acute/chronic kidney damage may present as a clinical manifestation of rheumatic diseases. In addition treatment with DMARDs or biologic drugs may induce nephrotoxicity. In this case-based review, we present two patients with SpA under anti-TNF-α treatment admitted to our hospital because of renal failure and proteinuria. We review previously published yet isolated cases of TNF-α blocker-induced glomerular disease in patients with SpA. Renal manifestations are occasionally seen in patients with ankylosing spondylitis and psoriatic arthritis with IgA nephropathy being the most common of them. Anti-TNF-α agents although reportedly used for the treatment of glomerular nephropathy as a disease manifestation, they have been considered responsible for provoking renal damage in some cases. A diagnostic approach for patients with SpA treated with anti-TNF-α agents presenting with renal manifestations is proposed herein.
肾衰竭或急/慢性肾损伤可能表现为风湿性疾病的临床症状。此外，使用改善病情抗风湿药（DMARDs）或生物药物进行治疗可能会诱发肾毒性。在本病例回顾中，我们介绍了两名因肾衰竭和蛋白尿而入住我院接受抗TNF-α治疗的脊柱关节炎（SpA）患者。我们回顾了先前发表的但较为孤立的SpA患者中TNF-α阻滞剂诱导的肾小球疾病病例。在强直性脊柱炎和银屑病关节炎患者中偶尔可见肾脏表现，其中IgA肾病最为常见。尽管据报道抗TNF-α药物可用于治疗作为疾病表现的肾小球肾病，但在某些情况下它们被认为是导致肾损伤的原因。本文提出了针对接受抗TNF-α药物治疗且出现肾脏表现的SpA患者的诊断方法。
