Display options
Cite
Plant R, Rafi Ahmed A, Mchale T, et al. A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis. Cureus. 2021;13(6):e15986doi: 10.7759/cureus.15986.
Plant, R., Rafi Ahmed, A., Mchale, T., & Giblin, L. (2021). A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis. Cureus, 13(6), e15986. https://doi.org/10.7759/cureus.15986
Plant, Rory, et al. "A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis." Cureus vol. 13,6 (2021): e15986. doi: https://doi.org/10.7759/cureus.15986
Plant R, Rafi Ahmed A, Mchale T, Giblin L. A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis. Cureus. 2021 Jun 28;13(6):e15986. doi: 10.7759/cureus.15986. eCollection 2021 Jun. PMID: 34336477; PMCID: PMC8317671.
Copy Download .nbib Format: NLM
Share it on

Cureus. 2021 Jun 28;13(6):e15986. doi: 10.7759/cureus.15986. eCollection 2021 Jun.

A Case of Adalimumab-Induced Granulomatous Interstitial Nephritis.

Cureus

Rory Plant, Adeel Rafi Ahmed, Teresa Mchale, Louise Giblin

Affiliations

  1. Nephrology, University Hospital Galway, Galway, IRL.
  2. Health Sciences, University of South Wales, Newport, GBR.
  3. Pathology and Laboratory Medicine, University Hospital Galway, Galway, IRL.

PMID: 34336477 PMCID: PMC8317671 DOI: 10.7759/cureus.15986

Abstract

Adalimumab is a monoclonal antibody targeting tumour necrosis factor-alpha (TNF-alpha) and is used for the treatment of numerous autoimmune conditions. There is a paucity of evidence linking adalimumab with granulomatous interstitial nephritis (GIN). We describe a renal biopsy-proven case of GIN secondary to adalimumab therapy. A 52-year-old gentleman with a background of psoriatic arthropathy was referred to the nephrology department by his general practitioner with a progressive decline in renal function over 18 months after initiating adalimumab. A renal biopsy confirmed tubulointerstitial nephritis with focal aggregates of histiocytes, organized as granulomata. Screening for other GIN causing aetiology, including tuberculosis (TB) and sarcoidosis, was negative. Adalimumab was withheld, leading to a slow improvement in renal function over a course of six months. It is essential to monitor renal function when administrating anti-TNF alpha agents as they can rarely paradoxically cause autoimmune reactions such as GIN seen in our case.

Copyright © 2021, Plant et al.

Keywords: : acute kidney injury; adalimumab; anti-tumour necrosis factor-alpha (anti-tnf-alpha); chronic kidney disease (ckd); drug reaction; granulomatous interstitial nephritis; tumour necrosis factor-α (tnf-α)

Conflict of interest statement

The authors have declared that no competing interests exist.

References

  1. Am J Kidney Dis. 2010 Dec;56(6):e17-21 - PubMed
  2. Clin Kidney J. 2018 Apr;11(2):219-221 - PubMed
  3. Clin Kidney J. 2015 Oct;8(5):516-23 - PubMed
  4. Clin Exp Rheumatol. 2008 May-Jun;26(3):471-5 - PubMed
  5. Rheumatology (Oxford). 2009 Aug;48(8):883-6 - PubMed
  6. NDT Plus. 2009 Apr;2(2):139-42 - PubMed
  7. Clin J Am Soc Nephrol. 2007 Mar;2(2):222-30 - PubMed
  8. Aust Fam Physician. 2007 Dec;36(12):1035-8 - PubMed
  9. Autoimmun Rev. 2013 May;12(7):703-8 - PubMed

Publication Types