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Boussaid S, Tbini H, Rekik S, Mami I, Ben Fatma L, Jammali S, Bargaoui H, Sahli H, Rais L, Zouaghi MK, Elleuch M. Focal Segmental Glomerulosclerosis and Hyalinosis in a Patient with Spondyloarthritis: A Rare Renal Involvement Case Report. Mediterr J Rheumatol 2023; 34:257-261. [PMID: 37654640 PMCID: PMC10466365 DOI: 10.31138/mjr.34.2.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 09/02/2023] Open
Abstract
Background During its course, spondyloarthritis (SpA) may be associated with extra-articular manifestations affecting several organs. Renal involvement is one of the most common extra-articular manifestations and is dominated by secondary amyloidosis (AA), immunoglobulin A (IgA) nephropathy, and urolithiasis. Other nephropathies such as Focal segmental glomerulosclerosis and hyalinosis (FSGS) are less common and are limited to few case reports. Case We report the case of a patient followed for axial SpA, who consulted, after being lost to follow-up for 3 years, for elevated blood pressure and edema of both lower limbs associated with an hydrocele and bilateral pleural effusion. Biological examinations showed hypoproteinemia, hypoalbuminemia, and proteinuria. In this context of nephrotic syndrome, the diagnosis of FSGS was confirmed by renal biopsy. Furthermore, the etiological investigation ruled out the causes of secondary FSGS. Conclusion Renal involvement is a sign of severity in SpA. Its detection and management should be part of the overall management of SpA.
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Affiliation(s)
- Soumaya Boussaid
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Houssem Tbini
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Sonia Rekik
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Ikram Mami
- Nephrology, Dialysis, and Renal Transplantation Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Lilia Ben Fatma
- Nephrology, Dialysis, and Renal Transplantation Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Samia Jammali
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Hela Bargaoui
- Nephrology, Dialysis, and Renal Transplantation Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Hela Sahli
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Lamia Rais
- Nephrology, Dialysis, and Renal Transplantation Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Mohamed Karim Zouaghi
- Nephrology, Dialysis, and Renal Transplantation Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Mohamed Elleuch
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
- Faculty of Medicine of Tunis, University Tunis El Manar, Tunis, Tunisia
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