A case of the secondary AA amyloidosis in Bekhterev’s disease: a successful 3-year therapy with adalimumab
DOI:
https://doi.org/10.22141/2307-1257.9.2.2020.203413Keywords:
ankylosing spondylitis (Bekhterev’s disease), adalimumab, secondary amyloidosis, AA amyloidosis, chronic kidney diseaseAbstract
Clinical observation of a patient suffering from rheumatic disease, which is identified as ankylosing spondylitis in the last 5 years and is described for more than 20 years. The progression of ankylosing spondylitis was complicated by the development of nephrotic syndrome and a progressive decrease in renal function to the level of CKD 4 (estimated glomerular filtration rate (eGFR) EPI 19.8 ml/min), anaemia and cachexia. A gum biopsy did not reveal amyloid; a kidney biopsy confirmed the presence of AA amyloidosis. Adalimumab therapy was started at a dose of 40 mg per week, after 2 months — once every 2 weeks. At the same time, the patient received olmesartan and symptomatic therapy. The three-year administration of adalimumab has led to a tight control of the activity of ankylosing spondylitis and a gradual restoration of renal function to eGFR 62 ml/min. During this treatment, the patient delivered of 2 children. A detailed description of kidney biopsy is given. Treatment with adalimumab and olmesartan is still continuing.
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Copyright (c) 2020 D.D. Ivanov, O.H. Fedorenko, O.O. Dyadik
This work is licensed under a Creative Commons Attribution 4.0 International License.