Adalimumab-associated IgA nephropathy and erythroderma in a patient with psoriasis
10.3760/cma.j.cn114015-20211124-01186
- VernacularTitle:阿达木单抗致银屑病患者IgA肾病和红皮病
- Author:
Ting LIU
1
;
Xiaohong FAN
;
Yueping ZENG
;
Yan QIN
;
Sanxi AI
;
Xuemei LI
Author Information
1. 中国医学科学院北京协和医学院北京协和医院内科，北京 100730
- Publication Type:Journal Article
- Keywords:
Adalimumab;
Glomerulonephritis, IgA;
Psoriasis;
Disease progression
- From:
Adverse Drug Reactions Journal
2022;24(6):332-334
- CountryChina
- Language:Chinese
-
Abstract:
A 69-year-old man was treated with adalimumab 80 mg subcutaneously for psoriasis for the first time. Two days later, the patient developed diffuse erythema with pruritus. Because the active stage of psoriasis was not excluded, adalimumab 40 mg subcutaneous injection was continued once a week for 4 times. The patient′s skin erythema and pruritus continued to worsen. After intravenous infusion of methylprednisolone sodium succinate 40 mg/d for 1 week, the systemic erythema and pruritus were slightly relieved, but the condition was repeated after stopping the drug. Urine routine and sediment analysis showed urinary occult blood (+++), 190 red blood cells/μl, urinary protein (+) , and serum creatinine 80 μmol/L. Renal biopsy and skin histopathology suggested IgA nephropathy and psoriasiform dermatitis, respectively. After consultation with dermatologists, erythroderma caused by deterioration of psoriasis was considered. Excluding other factors, it is considered that IgA nephropathy and erythroderma were probably induced by adalimumab. Methotrexate 10 mg per week was given orally and halometasone ointment was used externally. The skin damage in the patient was gradually improved. Hematuria and proteinuria were self-relieved slowly.At one-year of follow-up, the patient′s renal function and urine routine remained normal, and nephropathy and rash did not recur.
