Skip to main content

Advertisement

SpringerLink
Log in

A case of secondary IgA nephropathy accompanied by psoriasis treated with secukinumab

  • Case Report
  • Published:
CEN Case Reports Aims and scope Submit manuscript

Abstract

A 60-year-old man was diagnosed with psoriasis 4 years ago. Treatment with adalimumab (a monoclonal anti-TNF-α antibody) became ineffective 1 year ago, and proteinuria and urinary occult blood were detected. Treatment with topical medicine, ultraviolet therapy, and etretinate resulted in remission of psoriasis, and proteinuria and hematuria also improved. For maintenance of remission, treatment with secukinumab (a human anti-interleukin-17A monoclonal antibody) was initiated. After the induction phase, treatment was changed from once a week to once every 4 weeks. After 5 months, he developed nephritis with kidney dysfunction, hematuria, and severe proteinuria (14 g/g Cr) accompanied by pitting edema. After admission, treatment with secukinumab was continued. Kidney biopsy revealed IgA nephropathy with fibrocellular crescents, and immunofluorescence analysis did not detect galactose-deficient IgA1. With these findings, he was diagnosed as secondary IgA nephropathy associated with psoriasis. Tonsillectomy followed by steroid pulse therapy prevented proteinuria and kidney function. In this case, treatment of refractory psoriasis with secukinumab and tonsillectomy was effective, leading to remission of relapsing secondary IgA nephropathy. Therefore, secukinumab might play an immunological role in the treatment of nephropathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Nestle FO, Kaplan DH, Barker J. Psoriasis. N Engl J Med. 2009;361(5):496–509.

    Article  CAS  PubMed  Google Scholar 

  2. Wan J, Wang S, Haynes K, Denburg MR, Shin DB, Gelfand JM. Risk of moderate to advanced kidney disease in patients with psoriasis: population based cohort study. BMJ. 2013;347:f5961.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chiu HY, Huang HL, Li CH, Yin YJ, Chen HA, Hsu ST, et al. Increased risk of glomerulonephritis and chronic kidney disease in relation to the severity of psoriasis, concomitant medication, and comorbidity: a nationwide population-based cohort study. Br J Dermatol. 2015;173(1):146–54.

    Article  PubMed  Google Scholar 

  4. Pouria S, Barratt J. Secondary IgA nephropathy. Semin Nephrol. 2008;28(1):27–37.

    Article  PubMed  Google Scholar 

  5. Bagel J, Duffin KC, Moore A, Ferris LK, Siu K, Steadman J, et al. The effect of secukinumab on moderate-to-severe scalp psoriasis: results of a 24-week, randomized, double-blind, placebo-controlled phase 3b study. J Am Acad Dermatol. 2017;77:667–74.

    Article  CAS  PubMed  Google Scholar 

  6. Armstrong AW, Villanueva Quintero DG, Echeverria CM, Gu Y, Karunaratne M, Reyes Servin O. Body region involvement and quality of life in psoriasis: analysis of a randomized controlled trial of adalimumab. Am J Clin Dermatol. 2016;17(6):691–9.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Suzuki H, Yasutake J, Makita Y, Tanbo Y, Yamasaki K, Sofue T, et al. IgA nephropathy and IgA vasculitis with nephritis have a shared feature involving galactose-deficient IgA1-oriented pathogenesis. Kidney Int. 2018;93(3):700–5.

    Article  CAS  PubMed  Google Scholar 

  8. Ahuja TS, Funtanilla M, de Groot JJ, Velasco A, Badalamenti J, Wilson S. IgA nephropathy in psoriasis. Am J Nephrol. 1998;18(5):425–9.

    Article  CAS  PubMed  Google Scholar 

  9. Zadrazil J, Tichý T, Horák P, Nikorjaková I, Zíma P, Krejcí K, et al. IgA nephropathy associated with psoriasis vulgaris: a contribution to the entity of’psoriatic nephropathy’. J Nephrol. 2006;19(3):382–6.

    CAS  PubMed  Google Scholar 

  10. Turner JE, Krebs C, Tittel AP, Paust HJ, Meyer-Schwesinger C, Bennstein SB, et al. IL-17A production by renal gammadelta T cells promotes kidney injury in crescentic GN. J Am Soc Nephrol JASN. 2012;23(9):1486–95.

    Article  CAS  PubMed  Google Scholar 

  11. Papotto PH, Ribot JC, Silva-Santos B. IL-17 + gammadelta T cells as kick-starters of inflammation. Nat Immunol. 2017;18(6):604–11.

    Article  CAS  PubMed  Google Scholar 

  12. Cai Y, Shen X, Ding C, Qi C, Li K, Li X, et al. Pivotal role of dermal IL-17-producing gammadelta T cells in skin inflammation. Immunity. 2011;35(4):596–610.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Falk MC, Ng G, Zhang GY, Fanning GC, Roy LP, Bannister KM, et al. Infiltration of the kidney by alpha beta and gamma delta T cells: effect on progression in IgA nephropathy. Kidney Int. 1995;47(1):177–85.

    Article  CAS  PubMed  Google Scholar 

  14. Bonnet F, Deprele C, Sassolas A, Moulin P, Berthezène F, Berthoux F. Excessive body weight as a new independent risk factor for clinical and pathological progression in primary IgA nephritis. Am J Kidney Dis. 2001;37(4):720–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Nephrology, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan

    Masahiko Ochi, Tadashi Toyama, Mai Ando, Koichi Sato, Yasutaka Kamikawa, Akihiro Sagara, Shinji Kitajima, Akinori Hara, Yasunori Iwata, Norihiko Sakai, Miho Shimizu, Kengo Furuichi & Takashi Wada

  2. Department of Dermatology, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan

    Yasuhito Hamaguchi

  3. Department of System Biology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Ishikawa, Japan

    Masahiko Ochi, Tadashi Toyama, Mai Ando, Koichi Sato, Yasutaka Kamikawa, Akihiro Sagara, Shinji Kitajima, Akinori Hara, Yasunori Iwata, Norihiko Sakai, Miho Shimizu, Kengo Furuichi & Shuichi Kaneko

  4. Department of Nephrology and Laboratory Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan

    Takashi Wada

Authors
  1. Masahiko Ochi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tadashi Toyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mai Ando
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Koichi Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yasutaka Kamikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Akihiro Sagara
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shinji Kitajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Akinori Hara
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yasunori Iwata
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Norihiko Sakai
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Miho Shimizu
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kengo Furuichi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Yasuhito Hamaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Shuichi Kaneko
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Takashi Wada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tadashi Toyama.

Ethics declarations

Conflict of interest

All the authors have declared no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

Informed consent was obtained from the participant included in this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ochi, M., Toyama, T., Ando, M. et al. A case of secondary IgA nephropathy accompanied by psoriasis treated with secukinumab. CEN Case Rep 8, 200–204 (2019). https://doi.org/10.1007/s13730-019-00393-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13730-019-00393-5

Keywords

Search

Navigation