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Nephrotic Syndrome in a Multiple Sclerosis Patient Treated with Interferon β1a

Published online by Cambridge University Press:  02 December 2014

Anthony Auty  and
Abdulkarim Saleh
Anthony Auty*
Affiliation:
Division of Neurology, Department of Medicine, Shaikh Khalifa Medical Centre, Abu Dhabi, United Arab Emirates
Abdulkarim Saleh
Affiliation:
Division of Neurology, Department of Medicine, Shaikh Khalifa Medical Centre, Abu Dhabi, United Arab Emirates
*
Division of Neurology, Department of Medicine, Shaikh Khalifa Medical Centre, PO Box 51900, Abu Dhabi, United Arab Emirates.
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Abstract:

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Background:

Interferon β has become standard therapy for reducing relapse frequency in relapsing/remitting Multiple Sclerosis (RRMS). Several different preparations are available including interferon β1a (Avonex, Rebif) and interferon β1b (Betaferon/Betaseron). For the most part these preparations have been considered safe. Recently there have been concerns relating to liver1 and now kidney toxicity.

Case Report:

We present a case of a 28-yr old male who developed a severe case of nephrotic syndrome while being treated for relapsing/remitting Multiple Sclerosis (RRMS) with weekly injections of interferon β1a.

Subsequent course:

The nephrosis resolved almost completely once the interferon was stopped and after immunosuppressive treatment. At its peak the daily protein loss was 35.82 g. Kidney biopsy demonstrated membranous glomerulonephritis.

Discussion:

Two other case reports of nephrotic syndrome have been reported in the literature. This latest (third) report suggests that the safety profile should be reexamined and at least raises the question of potential renal toxicity of interferons in MS.

Résumé:

RÉSUMÉ: Introduction:

L’interféron b est devenu le traitement standard pour diminuer la fréquence des récidives dans la sclérose en plaques récurrente/rémittente (SEPRR). Plusieurs préparations différentes sont disponibles don’t l’interféron 1a (Avonex, Rebif) et l’interféron 1b (Betaferon/Betaseron). En général, on considérait que ces préparations étaient sûres. Depuis peu, on s’inquiète de leur toxicité hépatique et maintenant de leur toxicité rénale.

Observation:

Nous rapportons le cas d’un patient de 28 ans, originaire des Émirats arabes unis, qui a développé un syndrome néphritique aigu au cours du traitement de sa SEPRR au moyen d’injections hebdomadaires d’interféron b1a.

Suivi:

La néphrose a presque complètement disparu suite à l’arrêt du traitement et à un traitement immunosuppresseur. En phase aiguë, la perte quotidienne de protéines était de 35,82 g. La biopsie rénale a montré qu’il s’agissait d’une glomérulonéphrite membraneuse.

Discussion:

Deux autres cas de syndrome néphritique ont été rapportés dans la littérature. Ce troisième cas indique que le profil de sécurité des interférons devrait être réexaminé et soulève des questions concernant leur toxicité rénale chez les patients atteints de la SEP.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 32 , Issue 3 , August 2005 , pp. 366 - 368
Copyright
Copyright © The Canadian Journal of Neurological 2005

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