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Development of myeloperoxidase-antineutrophil cytoplasmic antibody-associated renal vasculitis in a patient receiving treatment with anti-tumor necrosis factor-α.

Abstract
We report on a 33-year-old woman who presented with positive myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) during rheumatoid arthritis treatment with infliximab. She had a history of worsening arthralgia, and urinalysis showed the new occurrence of hematuria and proteinuria. Renal biopsy showed necrotizing crescentic glomerulonephritis. Immunosuppressive therapy and discontinuation of the infliximab therapy alleviated her arthralgia and improved the urinalysis results. We report this rare case in which an anti-tumor necrosis factor-α (TNF-α) agent for ANCA-associated systemic vasculitis was studied.
AuthorsDaigoro Hirohama, Junichi Hoshino, Eiko Hasegawa, Masayuki Yamanouchi, Noriko Hayami, Tatsuya Suwabe, Naoki Sawa, Fumi Takemoto, Yoshifumi Ubara, Shigeko Hara, Kenichi Ohashi, Kenmei Takaichi
JournalModern rheumatology (Mod Rheumatol) Vol. 20 Issue 6 Pg. 602-5 (Dec 2010) ISSN: 1439-7609 [Electronic] England
PMID20680377 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antibodies, Antineutrophil Cytoplasmic
  • Antibodies, Monoclonal
  • Antirheumatic Agents
  • Glucocorticoids
  • Tumor Necrosis Factor-alpha
  • Prednisolone
  • Infliximab
  • Peroxidase
  • Methylprednisolone
Topics
  • Administration, Oral
  • Adult
  • Antibodies, Antineutrophil Cytoplasmic (blood)
  • Antibodies, Monoclonal (adverse effects)
  • Antirheumatic Agents (adverse effects)
  • Arthritis, Rheumatoid (drug therapy)
  • Drug Substitution
  • Female
  • Glucocorticoids (therapeutic use)
  • Humans
  • Infliximab
  • Injections, Intravenous
  • Kidney (blood supply, drug effects, immunology)
  • Kidney Diseases (chemically induced, immunology, pathology)
  • Methylprednisolone (therapeutic use)
  • Peroxidase (immunology)
  • Prednisolone (therapeutic use)
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha (antagonists & inhibitors)
  • Vasculitis (chemically induced, immunology, pathology)

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