Nephrotic syndrome as a complication of anti-TNFalpha in a patient with rheumatoid arthritis

Neth J Med. 2003 Apr;61(4):137-41.

Abstract

We describe a patient with rheumatoid arthritis (RA) who developed a nephrotic syndrome during treatment with a fully human recombinant monoclonal antibody against TNFalpha (adalimumab, Humira, Abbott). The proteinuria disappeared spontaneously after cessation of anti-TNFalpha treatment and relapsed after rechallenge, pointing to anti-TNFalpha as the culprit. Although renal biopsy disclosed a membranous glomerulopathy, the clinical picture was more compatible with minimal lesion glomerulopathy. The pathogenesis of this side effect is not clear; several mechanisms could in theory lead to these abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Adalimumab
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Arthritis, Rheumatoid / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Nephrotic Syndrome / etiology*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors*
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Tumor Necrosis Factor-alpha
  • Adalimumab