1. Renal diseases secondary to interferon-β treatment: a multicentre clinico-pathological study and systematic literature review
- Author
-
Marie-Flore Hennino, Vincent Audard, Jean-Jacques Boffa, David Buob, Cédric Rafat, Dominique Chauveau, Evangeline Pillebout, Vincent Vuiblet, Mathilde Lemoine, Maxime Dauvergne, Eric Daugas, Emilie Cornec-Le Gall, David Ribes, Département de Néphrologie [CHU Tenon] (Néphrologie et dialyse), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Common and Rare Kidney Diseases = Maladies Rénales Fréquentes et Rares: des Mécanismes Moléculaires à la Médecine Personnalisée (CORAKID), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service d’Anatomie et cytologie pathologiques [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Urgences néphrologiques et transplantation rénale [CHU Tenon], Centre hospitalier [Valenciennes, Nord], CHU Rouen, Normandie Université (NU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor, CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hopital Saint-Louis [AP-HP] (AP-HP), Centre Hospitalier Universitaire de Reims (CHU Reims), French Nephropathology Group, Service de Département de Néphrologie = Service de Néphrologie et Dialyses [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Maladies rénales fréquentes et rares : des mécanismes moléculaires à la médecine personnalisée (CoRaKID), Service d'Anatomie et cytologie pathologiques [CHU Tenon], Service d'Urgences néphrologiques et transplantation rénale [CHU Tenon], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and HAL-SU, Gestionnaire
- Subjects
Oncology ,medicine.medical_specialty ,030232 urology & nephrology ,urologic and male genital diseases ,interferon (IFN) ,03 medical and health sciences ,0302 clinical medicine ,Interferon β ,Internal medicine ,medicine ,AcademicSubjects/MED00340 ,Transplantation ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,business.industry ,nephrotic syndrome ,drug nephrotoxicity ,focal segmental glomerulosclerosis (FSGS) ,3. Good health ,Systematic review ,Nephrology ,thrombotic microangiopathy (TMA) ,Original Article ,Clinico pathological ,business ,030217 neurology & neurosurgery ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Background The spectrum of interferon-β (IFN-β)-associated nephropathy remains poorly described and the potential features of this uncommon association remain to be determined. Methods In this study we retrospectively analysed the clinical, laboratory, histological and therapeutic data of patients with biopsy-proven renal disease in a context of IFN-β treatment administered for at least 6 months. Results Eighteen patients (13 women, median age 48 years) with biopsy-proven renal disease occurring during IFN-β therapy were included. The median exposure to IFN-β (14 patients were treated with IFN-β1a and 4 patients with IFN-β1b) was 67 months (range 23–165 months). The clinical presentation consists in hypertension (HT; 83%), malignant HT (44%), proteinuria (protU) >1 g/g (94%), reduced renal function (78%), biological hallmark suggesting thrombotic microangiopathy (TMA; 61%), oedematous syndrome (17%) or nephritic syndrome (11%). The pathological findings included typical features of isolated TMAs in 11 cases, isolated focal segmental glomerulosclerosis (FSGS) lesions in 2 cases and 5 cases with concomitant TMA and FSGS lesions. An exploration of the alternative complement pathway performed in 10 cases (63%) did not identify mutations in genes that regulate the complement system. The statistical analysis highlighted that the occurrence of IFN-β-associated TMA was significantly associated with Rebif, with a weekly dose >50 µg and with multiple weekly injections. In all cases, IFN-β therapy was discontinued. Patients with TMA lesions received other therapies, including corticosteroids (44%), eculizumab (13%) and plasma exchanges (25%). At the end of a 36-month median follow-up, persistent HT and persistent protU were observed in 61% and 22% of patients, respectively. Estimated glomerular filtration rate, Graphical Abstract Graphical Abstract
- Published
- 2021