Table 2.
Demographic and clinical features of patients developing glomerulonephritis in isolated autoimmune renal disorders following treatment with a biologic or targeted synthetic drug
| Drug | Age, sex | IRD (duration) | Latency (months) | Associated features | Renal abnormalities | Kidney biopsy | Treatment | Outcome | WHO-UMC assessment | References |
|---|---|---|---|---|---|---|---|---|---|---|
| IFX | 40, F | AS (1 year) | 6 | Previous treatment with NSAIDs, SSZ | u-RBC, u-Prot (3.7 g/day) | FSGS | IFX, NSAIDs, SSZ withdrawal, IV MPRE, PRE, ACEi | Partial resolution | Probable | [23] |
| CTZ | 63, F | RA (15 years) | 6 | Arthritis, lower limbs edema, ↓alb, RF, ACPA, ANA | u-Prot (14 g/day) | MGN with glomerular sclerosis | CTZ withdrawal, diuretics and ACEi | Partial resolution | Certain | [24] |
| ABA | 60, F | RA, sSS (11 years) | 7 |
Edema, fatigue, lymphopenia, ↓alb, ↓complement, RF, ANA, ↑anti-dsDNA, Pre-existing PBC, T2DM Previous treatment with bucillamine, SSZ |
Casts, u-Prot (12.6 g/day) | MGN | ABA withdrawal, IV MPRE, PRE | Partial resolution | Possible | [25] |
| ADA | 62, M | RA (10 years) | 2 | Lower limb edema, ↑WBC, ↑CRP, ANA 1:80 homo, aCL IgG, MPO-ANCA, ↓C3, RF | u-RBC, u-Prot (5.41 g/day), ↓GFR (23 ml/min) | IgA mGN | ADA withdrawal, IV MPRE, PRE | Worsened (dialysis) | Probable | [26] |
| ABA | 76, F | RA (16 years) | NA | Polyarthritis, lower limbs edema | u-RBC, casts, ↑s-Cr, u-Prot (2.60 g/day) | IgA mGN, amyloidosis | ABA withdrawal, TOF | Complete resolution | Probable | [27] |
| TCZ | 48, F | RA (13 years) | 36 | Lower limbs edema, ANA 1:40 homo, Sm weakly +, ↓complement | u-RBC, u-Prot (3.5 g/day) | MP-GN | TCZ withdrawal, PRE, diuretics and ACEi | Complete resolution | Certain | [28] |
| TCZ | 74, M | RA (25 years) | 24 | Lower limbs edema, ↓complement | u-RBC, u-Prot (2.67 g/gCr), ↑s-Cr, ↓GFR (34 ml/min) | MP-GN | TCZ withdrawal, PRE | Worsened (death: severe infection) | Probable | [28] |
↓ indicates decreased, ↓alb hypoalbuminemia, ↑ indicates increased, ABA abatacept, ACEi angiotensin-converting enzyme inhibitor, aCL anti-cardiolipin, ACPA anti-citrullinated protein antibodies, ADA adalimumab, ANA antinuclear antibodies, AS ankylosing spondylitis, CRP C-reactive protein, CTZ certolizumab pegol, CYC cyclophosphamide, dsDNA double-stranded DNA, F female, FSGS focal segmental glomerular sclerosis, GFR glomerular filtration rate, IFX infliximab, IgA immunoglobulin A, IgG immunoglobulin G, IRD inflammatory rheumatic disease, IV intravenous, M male, MGN membranous glomerulonephritis, mGN mesangial glomerulonephritis, MP-GN membranoproliferative glomerulonephritis, MPO-ANCA myeloperoxidase anti-neutrophil cytoplasmic antibodies, MPRE methylprednisolone, NSAID nonsteroidal anti-inflammatory drug, PBC primary biliary cirrhosis, PRE prednisone, RA rheumatoid arthritis, RF rheumatoid factor, s-Cr serum creatinine, Sm anti-Smith autoantibody, sSS secondary Sjogren syndrome, SSZ sulfasalazine, T2DM type 2 diabetes mellitus, TCZ tocilizumab, TOF tofacitinib, u-Prot increased proteinuria, u-RBC urinary red blood cells (hematuria), WBC white blood cells, WHO-UMC World Health Organization Uppsala Monitoring Centre