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NDT Advance Access published online on June 25, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp314
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


IgA nephropathy associated with ankylosing spondylitis is not controlled by infliximab therapy

Antoine Jacquet1, Helene Francois1, Carlos Frangie1, Yasmina Yahiaoui1, Sophie Ferlicot1, Corinne Micelli2, Xavier Mariette2 and Antoine Durrbach1

1 Department of Nephrology, Kremlin Bicêtre hospital 2 Department of Rheumatology, Kremlin Bicêtre hospital, 94275 Le Kremlin Bicetre, France

Correspondence and offprint requests to: antoine.jacquet{at}hotmail.fr



  Abstract

The association between seronegative spondyloarthro- pathies and IgA nephropathy is well documented, mainly in cases of ankylosing spondylitis (AS). However, although these diseases have been associated, the physiopathological links between each other appear unclear. Anti-TNF{alpha} agents have transformed the outcome of axial forms of AS resistant to conventional anti-inflammatory therapies. Infliximab, a monoclonal anti-TNF{alpha} antibody, has greatly improved the evolution of AS although several adverse events have been described. On the other hand, infliximab has been demonstrated to reduce renal symptoms associated with chronic inflammatory rheumatological diseases, such as amyloid A (AA) amyloidosis, but few data are available on its efficacy in controlling IgA nephropathy associated with AS [1,2]. We report here a case of IgA nephropathy associated with AS that became symptomatic, whereas infliximab therapy efficiently controlled the rheumatological disease. This suggests that even though infliximab therapy effectively controls rheumatological manifestations, it may not be able to prevent IgA nephropathy associated with AS. Thus, this case report illustrates the complexity of the physiopathology of both diseases.

Keywords: ankylosing spondylitis; IgA nephropathy; infliximab; TNFalpha

Received for publication: 6. 5.09
Accepted in revised form: 3. 6.09


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