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image of Tubulointerstitial Nephritis in ANCA-Associated Vasculitis as a Rare Adverse Effect of Adalimumab: A Case Report

Abstract

Background

Patients with inflammatory disease treated with biological agents are at an increased risk of developing various adverse effects. However, little is known about the risk of nephrotoxicity, such as induced tubulointerstitial nephritis and involving the interstitium and renal tubule.

Case Presentation

We herein describe a case of biopsy-proven tubulointerstitial nephritis, induced by PR3-ANCA-associated vasculitis following adalimumab therapy in a patient with Crohn's disease and ankylosing spondylitis. We review the current evidence on adalimumabinduced nephrotoxicity and the potential underlying mechanisms.

Conclusion

Monitoring of renal function is strongly recommended in all patients treated with adalimumab. Early diagnosis of drug-induced tubulointerstitial nephritis due to vasculitis and immediate withdrawal of the offending drug are key to renal recovery and prevention from irreversible serious organ damage.

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2025-03-26
2025-05-28
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References

  1. Ellis C.R. Azmat C.E. Adalimumab. StatPearls. Internet Treasure Island, FL StatPearls Publishing 2024
    [Google Scholar]
  2. Torres J. Bonovas S. Doherty G. Kucharzik T. Gisbert J.P. Raine T. Adamina M. Armuzzi A. Bachmann O. Bager P. Biancone L. Bokemeyer B. Bossuyt P. Burisch J. Collins P. El-Hussuna A. Ellul P. Frei-Lanter C. Furfaro F. Gingert C. Gionchetti P. Gomollon F. González-Lorenzo M. Gordon H. Hlavaty T. Juillerat P. Katsanos K. Kopylov U. Krustins E. Lytras T. Maaser C. Magro F. Kenneth Marshall J. Myrelid P. Pellino G. Rosa I. Sabino J. Savarino E. Spinelli A. Stassen L. Uzzan M. Vavricka S. Verstockt B. Warusavitarne J. Zmora O. Fiorino G. ECCO Guidelines on therapeutics in Crohn’s disease: Medical treatment. J. Crohn’s Colitis 2020 14 1 4 22 10.1093/ecco‑jcc/jjz180 31711158
    [Google Scholar]
  3. Usui J. Salvatore S.P. Yamagata K. Seshan S.V. Clinicopathologic spectrum of renal lesions following anti-TNF-α inhibitor therapy: A single center experience. Kidney360 2023 4 3 363 373 10.34067/KID.0000000000000063 36706240
    [Google Scholar]
  4. Piga M. Chessa E. Ibba V. Mura V. Floris A. Cauli A. Mathieu A. Biologics-induced autoimmune renal disorders in chronic inflammatory rheumatic diseases: Systematic literature review and analysis of a monocentric cohort. Autoimmun. Rev. 2014 13 8 873 879 10.1016/j.autrev.2014.05.005 24840285
    [Google Scholar]
  5. Jennette J.C. Falk R.J. Bacon P.A. Basu N. Cid M.C. Ferrario F. Flores-Suarez L.F. Gross W.L. Guillevin L. Hagen E.C. Hoffman G.S. Jayne D.R. Kallenberg C.G.M. Lamprecht P. Langford C.A. Luqmani R.A. Mahr A.D. Matteson E.L. Merkel P.A. Ozen S. Pusey C.D. Rasmussen N. Rees A.J. Scott D.G.I. Specks U. Stone J.H. Takahashi K. Watts R.A. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013 65 1 1 11 10.1002/art.37715 23045170
    [Google Scholar]
  6. Sun X.J. Li Z.Y. Chen M. Pathogenesis of anti-neutrophil cytoplasmic antibody-associated vasculitis. Rheumatol. Immunol. Res. 2023 4 1 11 21 10.2478/rir‑2023‑0003 37138650
    [Google Scholar]
  7. Morimoto K. Kanzaki G. Niikura T. Koike K. Matsuo N. Maruyama Y. Tsuboi N. Yokoo T. Acute tubulointerstitial nephritis associated with antineutrophil cytoplasmic antibody following cimetidine treatment: A case report. BMC Nephrol. 2021 22 1 294 10.1186/s12882‑021‑02502‑y 34461843
    [Google Scholar]
  8. Nishimura S. Nakao K. Takeda M. Matsuura I. Nomura Y. Shojima S. Yamamura Y. Fujita K. Momoki N. Maruyama K. Yamamura M. Hiramatsu M. Antithyroid drug-associated MPO-ANCA-positive tubulointerstitial nephritis in a type 2 diabetes patient: A case report. CEN Case Rep. 2017 6 1 22 28 10.1007/s13730‑016‑0237‑y 28509121
    [Google Scholar]
  9. He X. Wen Y. Hu R. Wu H. Ye W. Yue C. Qin Y. Xia P. Chen L. Interstitial nephritis without glomerulonephritis in ANCA-associated vasculitis: A case series and literature review. Clin. Rheumatol. 2022 41 11 3551 3563 10.1007/s10067‑022‑06264‑2 35759125
    [Google Scholar]
  10. Plafkin C. Zhong W. Singh T. ANCA vasculitis presenting with acute interstitial nephritis without glomerular involvement. Clin. Nephrol. Case Stud. 2019 7 1 46 50 10.5414/CNCS109805 31346511
    [Google Scholar]
  11. Chandra T. Tabanor-Gayle J.A. Lakshminarayanan S. Adalimumab-induced anti-neutrophilic cytoplasmic antibody vasculitis: A rare complication of an increasingly common treatment. Cureus 2019 11 9 e5598 10.7759/cureus.5598 31700711
    [Google Scholar]
  12. Varas C.M. Heras M. Saiz A. Coloma R. Calle L. Callejas R. Molina Á. Rodríguez M.A. Fernández-Reyes Luis M.J. Antineutrophil cytoplasmic antibodies associated vasculitis in patient with Crohn’s disease treated with adalimumab. Nefrología (Engl. Ed.) 2017 37 5 560 561 10.1016/j.nefroe.2017.09.006 28946973
    [Google Scholar]
  13. Simms R. Kipgen D. Dahill S. Marshall D. Rodger R.S. ANCA-associated renal vasculitis following anti-tumor necrosis factor alpha therapy. Am. J. Kidney Dis. 2008 51 3 e11 e14 10.1053/j.ajkd.2007.10.043 18295046
    [Google Scholar]
  14. Fournier A. Nony A. Rifard K. Vascularite à anticorps anticytoplasme des polynucléaires neutrophiles chez une patiente traitée par adalimumab pour une polyarthrite rhumatoïde. Nephrol. Ther. 2009 5 7 652 657 10.1016/j.nephro.2009.03.005 19482531
    [Google Scholar]
  15. Weng C.H. Liu Z.C. Drug-induced anti-neutrophil cytoplasmic antibody-associated vasculitis. Chin. Med. J. (Engl.) 2019 132 23 2848 2855 10.1097/CM9.0000000000000539 31856057
    [Google Scholar]
  16. Hishida E. Kobayashi T. Ono Y. Oka K. Masuda T. Ueda Y. Akimoto T. Saito O. Nagata D. Tubulointerstitial nephritis in antineutrophil cytoplasmic antibody-associated vasculitis with monoclonal gammopathy. CEN Case Rep. 2022 11 1 36 42 10.1007/s13730‑021‑00620‑y 34282535
    [Google Scholar]
  17. Castro Corredor D. Sánchez de la Nieta M.D. de Lara Simón I.M. Acute tubulointerstitial nephritis in an HLA-B27-positive patient with axial spondyloarthritis being treated with adalimumab. Reumatol. Clín. (Engl. Ed.) 2019 15 3 179 181 10.1016/j.reumae.2017.03.011 28624373
    [Google Scholar]
  18. Mogairen S.M.A. Adalimumab induced chronic interstitial nephritis: a controlled blinded trial in mice. Int. J. Clin. Rheumatol. 2017 12 6 154 10.4172/1758‑4272.1000151
    [Google Scholar]
  19. Elaziz M.M.A. Fayed A. Patterns of renal involvement in a cohort of patients with inflammatory bowel disease in Egypt. Acta Gastroenterol. Belg. 2018 81 3 381 385 30350525
    [Google Scholar]
  20. Treffel M. Champigneulle J. Meibody F. Laurain E. Frimat L. Busby-Venner H. Tubulointerstitiel nephritis and Crohn’s disease, nephrotoxicity or extraintestinal manifestation of Crohn’s disease? About a case. Nephrol. Ther. 2019 15 1 59 62 10.1016/j.nephro.2018.07.406 30503098
    [Google Scholar]
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