LETTER

Benefit of anti-TNF treatment for nephrotic syndrome in a patient with juvenile inflammatory bowel disease associated spondyloarthropathy complicated with amyloidosis and glomerulonephritis

P Verschueren¹, F Lensen¹, E Lerut², K Claes³, R De Vos², B Van Damme², R Westhovens¹

¹ Department of Rheumatology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium
² Department of Morphology and Molecular Pathology, University Hospitals Leuven, Minderbroedersstraat 12, 3000 Leuven, Belgium
³ Department of Nephrology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium

Correspondence to:
Correspondence to:
Dr P Verschueren;
patrick.verschueren@uz.kuleuven.ac.be

Accepted 30 November 2002

Keywords: spondyloarthropathies; anti-tumour necrosis factor ; nephrotic syndrome; bowel disease

The first 150 words of the full text of this article appear below.

Historically, AA amyloidosis accounts for almost half of the deaths among patients with juvenile chronic arthritis, mainly due to complications of end stage renal failure.¹ Improved survival has been reported in patients whose underlying inflammatory disorder was brought to remission.² Tumour necrosis factor (TNF) blocking agents have been used successfully in the treatment of inflammatory disorders complicated with AA amyloidosis.^3–5 We report the effect of TNF in a case of AA amyloidosis secondary to juvenile spondyloarthropathy.

A 26 year old man with juvenile, inflammatory bowel disease associated spondyloarthropathy (HLA-B27+) was admitted to our hospital with proteinuria and ankle oedema.

He received combination therapy with methotrexate, sulfasalazine, methylprednisolone, and naproxen. His blood pressure was 130/80 mmHg. Table 1 shows the results of laboratory tests.

View this table: [in this window] [in a new window]   Table 1 Laboratory results at the time of admission

 

Ultrasound examination showed an increased bipolar size (130 mm) of both kidneys. A chest x ray examination was normal. . . . [Full text of this article]

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