Kosin Med J.  2018 Jun;33(1):85-90. 10.7180/kmj.2018.33.1.85.

IgA nephropathy in a patient with ankylosing spondylitis well controlled with etanercept

• Lee DH
• Kim GT
• Hwang NK
• Kim EH

• KMID: 2415843
• DOI: http://doi.org/10.7180/kmj.2018.33.1.85

Abstract

Ankylosing spondylitis (AS) can involve the eye, gastrointestinal system, cardiopulmonary system, skin, kidneys, and spinal and peripheral joints. It is rarely accompanied by immunoglobulin A (IgA) nephropathy. Although IgA is involved in both AS and IgA nephropathy, the relationship between these diseases remains unclear. We detected hematuria and proteinuria in a 32-year-old male patient with ankylosing spondylitis that remained stable for 4 years through treatment with etanercept, a tumor necrosis factor-α (TNF-α) inhibitor, and diagnosed IgA nephropathy through a renal biopsy. IgA nephropathy seems to be less commonly associated with AS disease activity or specific treatment such as TNF-α inhibitor use.

Keyword

Ankylosing spondylitis; IgA glomerulonephritis; Tumor necrosis factor alpha

MeSH Terms

Adult
Biopsy
Etanercept*
Glomerulonephritis, IGA*
Hematuria
Humans
Immunoglobulin A*
Joints
Kidney
Male
Necrosis
Proteinuria
Skin
Spondylitis, Ankylosing*
Tumor Necrosis Factor-alpha
Etanercept
Immunoglobulin A
Tumor Necrosis Factor-alpha

Figure

• 

  Fig. 1 Plain radiographs of the SI joint demonstrating grade 2 bilateral sacroiliitis. The film shows mild subchondral sclerosis and irregularities of the joint surfaces in both SI joints.

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  Fig. 2 (A) Light microscopy of a glomerulus demonstrating expansion of the mesangial matrix with mesangial hypercellularity (hematoxylin-eosin stain, ×400). (B) Immunofluorescence microscopy demonstrating anti-IgA intense staining within glomerular mesangium (fluorescence microscopy, ×400).

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