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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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Dauvergne M, Buob D, Rafat C, Hennino MF, Lemoine M, Audard V, Chauveau D, Ribes D, Cornec-Le Gall E, Daugas E, Pillebout E, Vuiblet V, Boffa JJ. Renal diseases secondary to interferon-β treatment: a multicentre clinico-pathological study and systematic literature review. Clin Kidney J 2021; 14:2563-2572. [PMID: 34950468 PMCID: PMC8690152 DOI: 10.1093/ckj/sfab114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/28/2021] [Indexed: 12/29/2022] Open
Abstract
Background The spectrum of interferon-β (IFN-β)-associated nephropathy remains poorly described and the potential features of this uncommon association remain to be determined. Methods In this study we retrospectively analysed the clinical, laboratory, histological and therapeutic data of patients with biopsy-proven renal disease in a context of IFN-β treatment administered for at least 6 months. Results Eighteen patients (13 women, median age 48 years) with biopsy-proven renal disease occurring during IFN-β therapy were included. The median exposure to IFN-β (14 patients were treated with IFN-β1a and 4 patients with IFN-β1b) was 67 months (range 23–165 months). The clinical presentation consists in hypertension (HT; 83%), malignant HT (44%), proteinuria (protU) >1 g/g (94%), reduced renal function (78%), biological hallmark suggesting thrombotic microangiopathy (TMA; 61%), oedematous syndrome (17%) or nephritic syndrome (11%). The pathological findings included typical features of isolated TMAs in 11 cases, isolated focal segmental glomerulosclerosis (FSGS) lesions in 2 cases and 5 cases with concomitant TMA and FSGS lesions. An exploration of the alternative complement pathway performed in 10 cases (63%) did not identify mutations in genes that regulate the complement system. The statistical analysis highlighted that the occurrence of IFN-β-associated TMA was significantly associated with Rebif, with a weekly dose >50 µg and with multiple weekly injections. In all cases, IFN-β therapy was discontinued. Patients with TMA lesions received other therapies, including corticosteroids (44%), eculizumab (13%) and plasma exchanges (25%). At the end of a 36-month median follow-up, persistent HT and persistent protU were observed in 61% and 22% of patients, respectively. Estimated glomerular filtration rate <60 mL/min/1.73 m2 was present in 61% of patients. Conclusions IFN-β-associated nephropathy must be sought in the case of HT and/or protU onset during treatment. When TMA and/or FSGS are observed on renal biopsy, early discontinuation of IFN-β is essential.
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Affiliation(s)
- Maxime Dauvergne
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service de Néphrologie et Dialyses, Paris, France
| | - David Buob
- Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Cédric Rafat
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Urgences Néphrologiques et Transplantation Rénale, Paris, France
| | - Marie-Flore Hennino
- Centre Hospitalier de Valenciennes, Service de Néphrologie, Valenciennes, France
| | - Mathilde Lemoine
- CHU de Rouen, Service de Néphrologie, Dialyse et Transplantation, Rouen, France
| | - Vincent Audard
- Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare Syndrome Néphrotique Idiopathique, Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders, Créteil, France
| | - Dominique Chauveau
- CHU Rangueil, Département de Néphrologie et Transplantation d'Organes et Centre de Référence Maladies Rénales Rares SORARE, Toulouse, France
| | - David Ribes
- CHU Rangueil, Département de Néphrologie et Transplantation d'Organes et Centre de Référence Maladies Rénales Rares SORARE, Toulouse, France
| | | | - Eric Daugas
- Assistance Publique des Hôpitaux de Paris, Hôpital Bichat, Service de Néphrologie, Paris, France
| | - Evangéline Pillebout
- Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Louis, Service de Néphrologie, Paris, France
| | - Vincent Vuiblet
- Département de Néphro-Pathologie, Unité de Pathologie, CHU Reims, Reims, France
| | - Jean-Jacques Boffa
- Assistance Publique des Hôpitaux de Paris, Hôpital Tenon, Service de Néphrologie et Dialyses, Paris, France
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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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