Abstract

BRIGANTE, Alejandro J. et al. ANCA associated vasculitis with atypical kidney biopsy in context of psoriasic arthritis: Case report and review. Rev. argent. reumatolg. [online]. 2018, vol.29, n.2, pp.57-60. ISSN 0327-4411.

Introduction: Anti-TNFα has changed the evolution and prognosis in psoriatic arthritis (PsA). Among the adverse events (AD) of these treatments, rapidly progressive glomerulonephritis (GNRP) has been described. In 80% of cases of GNRP, vasculitis is associated to ANCA (AAV). According to the literature, it is not unusual to find immune complex deposits (IC) in glomerular AAV lesions. There are publications of cases in which the presence of an AAV could be associated with the anti-TNFα therapy. Case: A 56-year-old woman with psoriatic arthritis under treatment with methotrexate and etanercept. Due to airway infection, etanercept is suspended and after the suspension evolves with nephritic syndrome with renal biopsy, which shows GN with uncharacteristic IC deposits and ANCA c / PR3 (+) in high titers. Conclusions: We present a patient in whom the manifestation of two entities, apparently unrelated, represents a diagnostic and therapeutic challenge. The relationship with the anti-TNFα treatment has been described, although its causal relationship can not be demonstrated. Most renal biopsies of AAV do not have immune deposits in the IF; although in a low percentage variable degrees of complement and immune complex deposits can be visualized.

Keywords : glomerulonephritis; ANCA; psoriatic arthritis.

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