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Alugba G, Urhi A, Olateju IV, Onyemarin H, Uzzi C, Oshiba-Fowode T, Obomanu E, Popoola HA, Okoronkwo EJ, Ukenenye E, Asaolu G, Oladunjoye AF, Oladunjoye O. Renal diseases associated with multiple sclerosis: A narrative review. Medicine (Baltimore) 2022; 101:e31959. [PMID: 36482579 PMCID: PMC9726425 DOI: 10.1097/md.0000000000031959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The mechanisms of renal pathology in multiple sclerosis (MS) can be related to the disease itself or its treatment. Although kidney disease can be associated with MS, not much has been reported in the literature; hence, our study aimed to describe the prevalence and types of renal diseases and discuss their prognosis in patients with MS. A literature search (2012-2022) was performed using the Scale for the Assessment of Narrative Review Articles. The databases searched included MEDLINE (PubMed) and EMBASE. Fourteen articles from these databases met the inclusion criteria. The inclusion criteria were as follows: publications with full-text access. Articles published in English. Original articles related to renal diseases in MS. The prevalence of renal diseases in MS from the articles obtained ranged from 0.74% to 2.49%. Interferon beta (IFN-β)-associated glomerulonephritis was common among the reviewed articles. Significant improvement and resolution of the pathology were observed after the discontinuation of the offending medication. Renal symptoms in 2 out of 4 cases with renal thrombotic microangiopathy (TMA) induced by interferon-beta progressed to chronic kidney disease, even after the drug was stopped. Other studied renal pathologies included nephrolithiasis secondary to urinary retention and urinary catheter use in patients with MS.
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Affiliation(s)
- Gabriel Alugba
- Delta State University, Abraka, Nigeria
- * Correspondence: Gabriel Alugba, Delta State University, P.M.B 1 Abraka, Delta State, Nigeria (e-mail: )
| | | | | | | | | | | | - Elvis Obomanu
- Department of Medicine, University of Portharcourt, Choba, Nigeria
| | | | | | - Emmanuel Ukenenye
- Medical Council of Jamaica, University of the West Indies, Kingston, Jamaica
| | - Gideon Asaolu
- Medical Council of Jamaica, University of the West Indies, Kingston, Jamaica
| | | | - Olubunmi Oladunjoye
- Department of General Internal Medicine, Baylor College of Medicine, Houston, TX, USA
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Iacopo G, Allinovi M, Caroti L, Cirami LC. Broad spectrum of interferon-related nephropathies—glomerulonephritis, systemic lupus erythematosus-like syndrome and thrombotic microangiopathy: A case report and review of literature. World J Nephrol 2019. [DOI: 10.5527/wjgo.v8.i7.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Gianassi I, Allinovi M, Caroti L, Cirami LC. Broad spectrum of interferon-related nephropathies-glomerulonephritis, systemic lupus erythematosus-like syndrome and thrombotic microangiopathy: A case report and review of literature. World J Nephrol 2019; 8:109-117. [PMID: 31750091 PMCID: PMC6853798 DOI: 10.5527/wjn.v8.i7.109] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/04/2019] [Accepted: 09/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Interferons (IFNs) are characterized by a wide range of biological effects, which justifies their potential therapeutic use in several pathologies, but also elicit a wide array of adverse effects in almost every organ system. Among them, renal involvement is probably one of the most complex to identify.
CASE SUMMARY We describe four cases of kidney damage caused by different IFN formulations: IFN-β-related thrombotic microangiopathy, IFN-β-induced systemic lupus erythematosus, and two cases of membranous nephropathy secondary to pegylated-IFN-α 2B. In each case, we carefully excluded any other possible cause of renal involvement. Once suspected as the casual relationship between drug and kidney damage, IFN treatment was immediately discontinued. In three cases, we observed a complete and persistent remission of clinical and laboratory abnormalities after IFN withdrawal, while the patient who developed thrombotic microangiopathy, despite IFN withdrawal and complement-inhibitor therapy with eculizumab, showed persistent severe renal failure requiring dialysis.
CONCLUSION This case series highlights the causal relationship between IFN treatment and different types of renal involvement and enables us to delineate several peculiarities of this association.
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Affiliation(s)
- Iacopo Gianassi
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence 50144, Italy
| | - Marco Allinovi
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence 50144, Italy
| | - Leonardo Caroti
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence 50144, Italy
| | - Lino Calogero Cirami
- Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence 50144, Italy
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Ozturk M, Basoglu F, Yilmaz M, Ozagari AA, Baybas S. Interferon β associated nephropathy in a Multiple Sclerosis patient: A case and review. Mult Scler Relat Disord 2016; 9:50-3. [PMID: 27645343 DOI: 10.1016/j.msard.2016.06.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 04/12/2016] [Accepted: 06/25/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Interferon beta (IFN β) subtypes are largely used as immunomodulatory agents in Multiple Sclerosis (MS) treatment. While being generally well tolerated, they can cause various side effects. Adverse effects related to kidney are rarely reported. CASE REPORT We report a 32 years old male patient who developed nephrotic syndrome while receiving IFN β for MS. Biopsy showed focal segmental glomerulosclerosis. He went into remisson after cessation of drug and with the aid of angiotensin II antagonists. Here, we report this case and a review of similar cases reported in literature. CONCLUSIONS Although it's a rare adverse effect and tend to show good prognosis physicians should pay careful attention to symptoms and findings of nephropathy during follow ups of patients under treatment with these agents.
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Affiliation(s)
- Musa Ozturk
- Department of Neurology, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Tevfik Saglam Cad No:25/2, 34147 Bakirkoy, Istanbul, Turkey.
| | - Fulya Basoglu
- Department of Neurology, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Tevfik Saglam Cad No:25/2, 34147 Bakirkoy, Istanbul, Turkey.
| | - Murvet Yilmaz
- Department of Nephrology, Bakirkoy Dr Sadi Konuk Reasaerch and Training Hospital, Tevfik Saglam Street No:11, 34147 Bakirkoy, Istanbul, Turkey.
| | - Ayse Aysim Ozagari
- Department of Pathology, Sisli Hamidiye Etfal Research and Training Hospital, Halaskargazi Boulevard, Etfal Street, 34360 Sisli, Istanbul, Turkey.
| | - Sevim Baybas
- Department of Neurology, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Tevfik Saglam Cad No:25/2, 34147 Bakirkoy, Istanbul, Turkey.
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Abstract
Nephrotic syndrome refers to excessive proteinuria, with associated hypoalbuminemia, edema, and hyperlipidemia. A diverse spectrum of disorders has been associated with nephrotic syndrome and related neurologic complications, although the relative infrequency of these cases limits conclusive associations. Neurologic manifestations of nephrotic syndrome may result from hypoproteinemia, hypercoagulability, hyperlipidemia, hypertension, amyloid deposition, hormonal changes, or electrolyte disorders. Neurologic diagnosis hinges on prompt recognition of this syndrome and rational therapeutic strategies are aimed at the underlying systemic disorder.
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Nerrant E, Charif M, Ramay AS, Perrochia H, Patrier L, de Champfleur NM, Renard D, Labauge P. Hemolytic uremic syndrome: an unusual complication of interferon-β treatment in a MS patient. J Neurol 2013; 260:1915-6. [PMID: 23708674 DOI: 10.1007/s00415-013-6961-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/06/2013] [Accepted: 05/07/2013] [Indexed: 12/23/2022]
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Ikeda K, Okamoto T, Yamamura T, Ohsawa I, Furutera R, Murata M. [Nephrotic syndrome in multiple sclerosis patients who had undergone long-term interferon β-1b therapy]. Rinsho Shinkeigaku 2013; 53:19-23. [PMID: 23328061 DOI: 10.5692/clinicalneurol.53.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 59-year-old man (case 1) with multiple sclerosis (MS) presented with shortness of breath and general fatigue. He had been treated using interferon β-1b (IFNβ-1b) since he was 51 years of age. Laboratory test results showed hypoproteinemia and hypoalbuminemia, proteinuria, and absence of hematuria. He was diagnosed with nephrotic syndrome, and the administration of IFNβ-1b was stopped. Percutaneous renal biopsy was performed, and the histology revealed membranous nephropathy. A 33-year-old woman (case 2) with MS, who had been treated using IFNβ-1b for 7 years, was diagnosed with proteinuria during a medical checkup. She was referred to a nephrologist and was found to have hypoalbuminemia and proteinuria. A diagnosis of nephrotic syndrome was made, and IFNβ-1b therapy was stopped. The patient underwent percutaneous renal biopsy, and the histology revealed membranous nephropathy. Both patients were treated using intravenous methylprednisolone followed by oral prednisolone. Case 1 was administered ciclosporin orally, and his clinical symptoms and laboratory test results improved at first, but his laboratory test results subsequently showed recurrence of proteinuria. Case 2 was administered mizoribine orally, resulting in improvement in clinical symptoms and laboratory test results. Case 2 showed relapse of multiple sclerosis, but the symptoms were mild and were alleviated after steroid therapy. IFNβ therapy has several complications including nephropathy. Previously, several cases of nephrotic syndrome associated with IFNβ within 2 years of therapy were reported, but drug-induced nephropathy could appear after several years of the therapy as our cases. We should pay attention to nephrotic syndrome under using long-term IFNβ.
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Affiliation(s)
- Kensuke Ikeda
- Department of Neurology, National Center Hospital, National Center of Neurology and Psychiatry
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Tornes L, Delgado S, Garcia-Buitrago M, Ortega MR, Rammohan KW. Focal segmental glomerulosclerosis secondary to subcutaneous interferon β-1a treatment in a patient with multiple sclerosis. Mult Scler Relat Disord 2012; 1:148-51. [DOI: 10.1016/j.msard.2012.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 01/31/2012] [Accepted: 02/09/2012] [Indexed: 11/15/2022]
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Olea T, Díaz-Mancebo R, Picazo ML, Martínez-Ara J, Robles A, Selgas R. Thrombotic microangiopathy associated with use of interferon-beta. Int J Nephrol Renovasc Dis 2012; 5:97-100. [PMID: 22815645 PMCID: PMC3399315 DOI: 10.2147/ijnrd.s30194] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Interferon-beta is widely used for the treatment of relapsing multiple sclerosis. The drug is usually well tolerated, but autoimmune adverse effects, including kidney disease, have been reported. Only a few cases of hemolytic uremic syndrome-thrombotic microangiopathy associated interferon-alpha have been described so far, and even fewer with beta-interferon. We report a patient who developed thrombotic microangiopathy during treatment with interferon-beta and improved after discontinuation and steroid therapy. Complement cascade and antiphospholipid antibodies are investigated. The spectrum of renal diseases associated with interferon-beta treatment is also reviewed.
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Affiliation(s)
- Teresa Olea
- Department of Nephrology, Hospital Universitario La Paz, Madrid, Spain
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Aravindan A, Yong J, Killingsworth M, Suranyi M, Wong J. Minimal change disease with interferon-beta therapy for relapsing remitting multiple sclerosis. Clin Kidney J 2009. [DOI: 10.1093/ndtplus/sfp162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Brule F, Khatissian E, Benani A, Bodeux A, Montagnier L, Piette J, Lauret E, Ravet E. Inhibition of HIV replication: A powerful antiviral strategy by IFN-β gene delivery in CD4+ cells. Biochem Pharmacol 2007; 74:898-910. [PMID: 17662695 DOI: 10.1016/j.bcp.2007.06.036] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 06/15/2007] [Accepted: 06/20/2007] [Indexed: 12/30/2022]
Abstract
In this study, we demonstrated the efficiency and feasibility of a gene therapy protocol against HIV infection using the antiviral effects of IFN-beta expression. Lentiviral vectors containing the human or the simian IFN-beta sequences under the influence of the murine moderate H2-kb promoter were constructed. To examine the capacity of IFN-beta to inhibit the replication of HIV in human CD4(+) cells, a transduction protocol permitting to efficiently transduce CD4(+) cells or PBMC (85+/-12% of CD4(+)-transduced cells) with a moderate expression of IFN-beta was developed. Results indicate that enforced expression of IFN-beta has no negative effects in terms of apoptosis and proliferation. In human CD4(+) cells, it drastically inhibits (up to 99.9%) replication after challenging with different strains of HIV-1. The expression of exogenous IFN-beta leads to an amplification of the CD4(+) cells (11-fold) and to a drastic decrease of the p24 protein. Micro-array analyses indicated that antiviral effect of IFN-beta could be due to a major regulation of the inflammatory response. These results are encouraging for the development of a clinical study of gene therapy against AIDS using IFN-beta.
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Affiliation(s)
- Fabienne Brule
- Laboratory of Virology & Immunology, University of Liège, B-4000 Liège, Belgium
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Kumasaka R, Nakamura N, Shirato K, Fujita T, Murakami R, Shimada M, Nakamura M, Osawa H, Yamabe H, Okumura K. Nephrotic syndrome associated with interferon-beta-1b therapy for multiple sclerosis. Clin Exp Nephrol 2006; 10:222-5. [PMID: 17009081 DOI: 10.1007/s10157-006-0424-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2006] [Accepted: 05/10/2006] [Indexed: 11/28/2022]
Abstract
A 43-year-old woman with multiple sclerosis (MS) had nephrotic syndrome 21 months after starting treatment with interferon (IFN)-beta-1b (subcutaneous administration). She had taken no drug except for the IFN-beta-1b. Because nephrotic syndrome may be induced by IFN therapy, the IFN was stopped. Percutaneous renal biopsy revealed that she had minimal change nephrotic syndrome. As nephrotic-range proteinuria, hypoalbuminemia, and general edema were worsening even 2 weeks after cessation of the drug, oral corticosteroid therapy (prednisolone 40 mg/day) was started. The nephrotic syndrome was treated successfully with prednisolone. The dosage of prednisolone was tapered, without a relapse, and then the corticosteroid therapy was stopped. IFN-beta-1b therapy was then resumed, and the patient is in remission for both nephrotic syndrome and MS. Though proteinuria and nephrotic syndrome is a rare adverse effect of IFN-beta-1b therapy, physicians treating MS patients with this agent should pay careful attention to new clinical symptoms and laboratory findings.
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Affiliation(s)
- Ryuichiro Kumasaka
- The Second Department of Internal Medicine, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
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Karie S, Launay-Vacher V, Izzedine H, Deray G. Néphrotoxicité des médicaments: veille bibliographique janvier 2003–décembre 2005. Nephrol Ther 2006; 2:368-78. [PMID: 17081959 DOI: 10.1016/j.nephro.2006.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2006] [Accepted: 07/20/2006] [Indexed: 01/19/2023]
Abstract
Drug-induced kidney injury is a major side effect in clinical practice. Renal injury associated with drugs may involve several components of the kidney: glomerulus, tubules, interstitium, and blood vessels. Acute renal failure may occur as a major reaction to many drugs. Moreover, therapeutic agents may induce an allergic reaction leading to interstitial inflammation and tubular damage. In this article, we present an updated version of the bibliography containing the case reports of nephrotoxicity published in the international literature from January 2003 to December 2005.
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Affiliation(s)
- Svetlana Karie
- ICAR, service de néphrologie, groupe hospitalier de la Pitié-Salpêtrière, 83, boulevard de l'Hôpital, 75015 Paris, France.
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