Acute tubulointerstitial nephritis possibly caused by vedolizumab for ulcerative colitis in a kidney transplant recipient: A case report.

IF 1.1 4区 医学 Q3 UROLOGY & NEPHROLOGY
Masatomo Ogata, Masahiko Yazawa, Maho Terashita, Kiyomi Osako, Sayuri Shirai
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Abstract

Vedolizumab, which is used to effectively treat ulcerative colitis (UC), is a humanized monoclonal antibody that specifically inhibits α4β7 integrin on lymphocytes and prevents lymphocyte migration into the intestinal tissues. Herein, we report a case of acute tubulointerstitial nephritis (ATIN) probably caused by vedolizumab in a kidney transplant recipient (KR) with UC. Approximately 4 years after kidney transplantation, the patient developed UC and was treated initially with mesalazine. Treatment continued with the addition of infliximab later; however, he was hospitalized because of poor symptom control and treated with vedolizumab. His graft function declined rapidly after vedolizumab was administered. Allograft biopsy revealed ATIN. Since no evidence of graft rejection was found, vedolizumab-associated ATIN was diagnosed. The patient was treated with steroids, and his graft function improved. Unfortunately, he finally underwent total colectomy considering that UC was refractory to medical treatment. Previously, cases of vedolizumab-induced acute interstitial nephritis have been reported; however, none were associated with KRs. This is the first report of ATIN in KR which was possibly induced by vedolizumab.

肾移植受者溃疡性结肠炎可能由维多单抗引起的急性肾小管间质性肾炎:1例报告。
Vedolizumab是一种人源化单克隆抗体,特异性抑制淋巴细胞上的α4β7整合素,阻止淋巴细胞向肠道组织迁移,用于有效治疗溃疡性结肠炎(UC)。在此,我们报告一例急性肾小管间质性肾炎(ATIN),可能是由维多单抗引起的,发生在患有UC的肾移植受体(KR)中。肾移植后大约4年,患者出现UC,最初使用美沙拉嗪治疗。治疗后继续加用英夫利昔单抗;然而,由于症状控制不佳,他住院并接受了维多单抗治疗。他的移植物功能在给予维多单抗后迅速下降。同种异体移植活检显示ATIN。由于没有发现移植排斥反应的证据,因此诊断为维多单抗相关ATIN。患者接受类固醇治疗后,移植物功能得到改善。不幸的是,考虑到UC的药物治疗难治性,他最终接受了全结肠切除术。以前,曾报道过维多单抗诱导的急性间质性肾炎病例;然而,没有一个与KRs相关。这是首次报道可能由vedolizumab诱导的KR中出现ATIN。
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来源期刊
Clinical nephrology
Clinical nephrology 医学-泌尿学与肾脏学
CiteScore
2.10
自引率
9.10%
发文量
138
审稿时长
4-8 weeks
期刊介绍: Clinical Nephrology appears monthly and publishes manuscripts containing original material with emphasis on the following topics: prophylaxis, pathophysiology, immunology, diagnosis, therapy, experimental approaches and dialysis and transplantation.
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