Focal segmental glomerulosclerosis in a patient with multiple sclerosis treated with Teriflunomide and Ocrelizumab

We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS progression, treatment was switched to Ocrelizumab. After 15 months of therapy with Ocrelizumab the patient developed edema and nephrotic-range albu...

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Published inJournal of nephrology Vol. 36; no. 3; pp. 659 - 661
Main Authors Greve, Anne-Sofie, Prakash, Sivagini, Krag, Søren, Randers, Else
Format Journal Article
LanguageEnglish
Published Cham Springer International Publishing 01.04.2023
Subjects
Adult
Albuminuria - chemically induced
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Case Report
Edema - chemically induced
Glomerulosclerosis, Focal Segmental - complications
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Male
Medicine
Medicine & Public Health
Multiple Sclerosis - drug therapy
Nephrology
Treatment Outcome
Urology
Online AccessGet full text

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Abstract We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS progression, treatment was switched to Ocrelizumab. After 15 months of therapy with Ocrelizumab the patient developed edema and nephrotic-range albuminuria. Kidney biopsy showed focal segmental glomerulosclerosis (FSGS) and Ocrelizumab treatment was stopped. Teriflunomide is less likely to have caused FSGS due to a three week wash-out period and a timespan of 15 months between the last Teriflunomide dose and development of albuminuria. Treatment with Ocrelizumab has been associated with organ-specific inflammation in MS-patients, thus an association between the development of FSGS and Ocrelizumab therapy is possible, and this case suggests considering this potential association.
AbstractList We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS progression, treatment was switched to Ocrelizumab. After 15 months of therapy with Ocrelizumab the patient developed edema and nephrotic-range albuminuria. Kidney biopsy showed focal segmental glomerulosclerosis (FSGS) and Ocrelizumab treatment was stopped. Teriflunomide is less likely to have caused FSGS due to a three week wash-out period and a timespan of 15 months between the last Teriflunomide dose and development of albuminuria. Treatment with Ocrelizumab has been associated with organ-specific inflammation in MS-patients, thus an association between the development of FSGS and Ocrelizumab therapy is possible, and this case suggests considering this potential association.
We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS progression, treatment was switched to Ocrelizumab. After 15 months of therapy with Ocrelizumab the patient developed edema and nephrotic-range albuminuria. Kidney biopsy showed focal segmental glomerulosclerosis (FSGS) and Ocrelizumab treatment was stopped. Teriflunomide is less likely to have caused FSGS due to a three week wash-out period and a timespan of 15 months between the last Teriflunomide dose and development of albuminuria. Treatment with Ocrelizumab has been associated with organ-specific inflammation in MS-patients, thus an association between the development of FSGS and Ocrelizumab therapy is possible, and this case suggests considering this potential association.
Author Prakash, Sivagini
Krag, Søren
Greve, Anne-Sofie
Randers, Else
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10.1111/j.1523-1755.2004.00426.x
10.2215/CJN.07311009
10.1097/TP.0000000000002352
10.1093/ckj/sfaa191
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10.1016/j.msard.2019.101866
10.1056/NEJMoa1601277
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10.1016/j.msard.2020.102506
10.1093/ibd/izaa057
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10.1016/j.msard.2019.01.044
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Snippet We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS...
We describe the case of a 24-year-old male patient with multiple sclerosis (MS) who was treated with Teriflunomide for eight months. However, due to MS...
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SubjectTerms Adult
Albuminuria - chemically induced
Antibodies, Monoclonal, Humanized - adverse effects
Antibodies, Monoclonal, Humanized - therapeutic use
Case Report
Edema - chemically induced
Glomerulosclerosis, Focal Segmental - complications
Humans
Immunosuppressive Agents - adverse effects
Immunosuppressive Agents - therapeutic use
Male
Medicine
Medicine & Public Health
Multiple Sclerosis - drug therapy
Nephrology
Treatment Outcome
Urology
Title Focal segmental glomerulosclerosis in a patient with multiple sclerosis treated with Teriflunomide and Ocrelizumab
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