Response to anti-TNF-α treatment for secondary renal amyloidosis in a patient with ankylosing spondylitis

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Renal amyloidosis is a complication of ankylosing spondylitis. A possible pathogenetic role is due to TNF-α, with a direct action on glomerular receptors TNFR2 and renal injury, secondary to deposition of amyloid fibrils. The most frequent clinical manifestation is proteinuria or nephrotic syndrome. Etanercept, a soluble receptor of TNF-α, binds this circulant cytokine with a progressive improvement of renal function and reduction of deposits of amyloid. Transient leukopenia, observed during ankylosing spondylitis, should not be considered a controindication to the use of Etanercept, but it requires a constant monitoring. The benefit observed in our patient can represent an indication to the use of Etanercept for the management of amyloidosis.

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Bellissimo, S., Ferrucci, M., Gallo, A., & Stisi, S. (2007). Response to anti-TNF-α treatment for secondary renal amyloidosis in a patient with ankylosing spondylitis. Reumatismo, 59(3), 240–243. https://doi.org/10.4081/reumatismo.2007.240