Shen Yan, Yuan Jin, Chen Shuang, Zhang Yong-Feng, Yin Ling, Hong Qin, Zha Yan
Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China.
World J Clin Cases. 2024 Oct 16;12(29):6307-6313. doi: 10.12998/wjcc.v12.i29.6307.
Telitacicept reduces B cell activation and abnormal immunoglobulin A (IgA) antibody production by inhibiting the activity of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), thereby decreasing IgA deposition in the glomeruli and local inflammatory response. This ultimately protects the kidneys from damage. This mechanism suggests that Telitacicept has potential efficacy in the treatment of IgA nephropathy.
We present the case of a 24-year-old female who was diagnosed with IgA nephropathy due to significant proteinuria and mild renal impairment. Pathologically, she exhibited focal proliferative glomerulonephritis. Treatment with angiotensin II receptor blocker, hormones, and mycophenolate mofetil did not lead to a significant improvement in her condition. However, upon the addition of telitacicept, the patient's renal function recovered and her proteinuria rapidly reduced. Hormones were swiftly tapered and discontinued, with no occurrence of severe infections or related complications.
Telitacicept combined with hormones and mycophenolate mofetil may be a safe and effective induction therapy for IgA nephropathy.
泰它西普通过抑制B淋巴细胞刺激因子（BLyS）和增殖诱导配体（APRIL）的活性，减少B细胞活化及异常免疫球蛋白A（IgA）抗体产生，从而减少IgA在肾小球的沉积及局部炎症反应。这最终保护肾脏免受损伤。该机制提示泰它西普在治疗IgA肾病方面具有潜在疗效。
我们报告一例24岁女性患者，因大量蛋白尿和轻度肾功能损害被诊断为IgA肾病。病理检查显示为局灶增生性肾小球肾炎。使用血管紧张素II受体阻滞剂、激素和霉酚酸酯治疗后，其病情未显著改善。然而，加用泰它西普后，患者肾功能恢复，蛋白尿迅速减少。激素迅速减量并停用，未发生严重感染或相关并发症。
泰它西普联合激素和霉酚酸酯可能是治疗IgA肾病的一种安全有效的诱导疗法。
