Open AccessUse of tocilizumab in amyloid a nephropathy associated with Sweet syndrome: a case report and literature review
Author(s) -
Domenico Giannese,
Francesco Ferro,
Diego Moriconi,
Angelo Giovanni Bonadio,
Elena Elefante,
Maria Francesca Egidi,
Adamasco Cupisti,
Chiara Baldini
Publication year - 2020
Publication title -
cen case reports
Language(s) - English
Resource type - Journals
ISSN - 2192-4449
DOI - 10.1007/s13730-020-00507-4
Subject(s) - medicine , tocilizumab , nephrotic syndrome , proteinuria , nephropathy , renal biopsy , nephrology , cyclophosphamide , kidney disease , gastroenterology , amyloidosis , renal function , kidney , rheumatoid arthritis , endocrinology , chemotherapy , diabetes mellitus
Amyloid A nephropathy is a possible complication of chronic inflammatory disease. Proteinuria and kidney failure are the main features of the disease. Tocilizumab (TCZ), an IL6-R antibody approved for rheumatoid arthritis, is a promising choice for histologically demonstrated nephropathy. We describe a case of kidney amyloid associated with Sweet syndrome treated with TCZ. The patient was affected by Sweet syndrome associated with proteinuria. Kidney biopsy showed amyloid deposits. During the follow-up, cutaneous and renal findings were refractory to many immunosuppressive regimen (cyclophosphamide, leflunomide, interferon and steroid). After few years, the patient developed rapidly progressive nephropathy associated with nephrotic syndrome (proteinuria up to 6 g/die). A second kidney biopsy was performed and it showed worsening of amyloid nephropathy. Thus, TCZ was administrated (8 mg/kg once a month) and it stabilized kidney function and induced partial remission of the nephrotic syndrome in the following 2 years.