Treatment with IFN-α, -β, or -γ Is Associated with Collapsing Focal Segmental Glomerulosclerosis
Open Access
- 1 April 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Journal of the American Society of Nephrology
- Vol. 5 (4), 607-615
- https://doi.org/10.2215/cjn.07311009
Abstract
Background and objectives: Treatment with IFN is rarely associated with nephrotic syndrome and renal biopsy findings of minimal-change disease or FSGS. Design, setting, participants, & measurements: We report 11 cases of collapsing FSGS that developed during treatment with IFN and improved after discontinuation of therapy. Results: The cohort consists of seven women and four men with a mean age of 48.2 yr. Ten of the 11 patients were black. Six patients were receiving IFN-α for hepatitis C virus infection (n = 5) or malignant melanoma (n = 1), three were receiving IFN-β for multiple sclerosis, and two were treated with IFN-γ for idiopathic pulmonary fibrosis. After a mean and median duration of therapy of 4.0 and 12.6 months, respectively, patients presented with acute renal failure (mean creatinine 3.5 mg/dl) and nephrotic-range proteinuria (mean 24-hour urine protein 9.7 g). Renal biopsy revealed collapsing FSGS with extensive foot process effacement and many endothelial tubuloreticular inclusions. Follow-up was available for 10 patients, all of whom discontinued IFN. At a mean of 23.6 months, nine of 10 patients had improvement in renal function, including one with complete remission and two with partial remission. Among the seven patients with available data, mean proteinuria declined from 9.9 to 3.0 g/d. Four of the seven patients were treated with immunosuppression, and there was no detectable benefit. Conclusions: Collapsing FSGS may occur after treatment with IFN-α, -β, or -γ and is typically accompanied by the ultrastructural finding of endothelial tubuloreticular inclusions. Optimal therapy includes discontinuation of IFN.Keywords
This publication has 65 references indexed in Scilit:
- Development of Focal Segmental Glomerulosclerosis after Anabolic Steroid AbuseJournal of the American Society of Nephrology, 2010
- Activation of Adenosine 2A Receptors Preserves Structure and Function of PodocytesJournal of the American Society of Nephrology, 2008
- Life-threatening thrombocytopenia and nephrotic syndrome due to focal segmental glomerulosclerosis associated with pegylated interferon ?-2b and ribavirin treatment for hepatitis CLiver International, 2006
- Nephrotic syndrome associated with interferon-β-1b therapy for multiple sclerosisClinical and Experimental Nephrology, 2006
- Is IgA nephropathy the commonest primary glomerulopathy among young adults in the USA?Kidney International, 2006
- Twenty-one-year trend in ESRD due to focal segmental glomerulosclerosis in the United StatesAmerican Journal of Kidney Diseases, 2004
- Acute onset of nephrotic syndrome during interferon-α retreatment for chronic active hepatitis CThe Esophagus, 2002
- Association of parvovirus B19 infection with idiopathic collapsing glomerulopathyKidney International, 2001
- Acute Renal Failure during Therapy with Recombinant Human Gamma InterferonNew England Journal of Medicine, 1988
- Acute Interstitial Nephritis with the Nephrotic Syndrome Following Recombinant Leukocyte A Interferon Therapy for Mycosis FungoidesNew England Journal of Medicine, 1984