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NDT Plus Advance Access originally published online on January 6, 2009
NDT Plus 2009 2(2):139-142; doi:10.1093/ndtplus/sfn200
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Treatment of sarcoid granulomatous interstitial nephritis with adalimumab

Roopali Gupta1, Lisa Beaudet2, Jack Moore1 and Tulsi Mehta1

1 Department of Nephrology
2 Department of Pathology, Washington Hospital Center, Washington, DC, USA

Correspondence: Correspondence and offprint requests to: Tulsi K. Mehta, MD, Section of Nephrology, 110 Irving Street, Suite 2A70, Washington, DC 20010, USA. Tel: +202-877-6034; Fax: +202-877-8329; E-mail: tulsi.mehta{at}medstar.net


  Abstract

Sarcoidosis is a systemic disease with multiorgan involvement which can cause renal failure through several different mechanisms. Granulomatous interstitial nephritis is an important albeit less frequent cause of clinically significant renal disease. Herein, we present the case of a 46 year old woman with a history of sarcoidosis whom we evaluated for rapidly worsening kidney function and proteinuria. Renal biopsy revealed granulomatous interstitial nephritis. After therapy with adalimumab, her renal function improved with a significant reduction in proteinuria. Repeat kidney biopsy showed resolution of renal granulomata. To our knowledge, this is the first report of successful treatment of granulomatous interstitial nephritis with adalimumab.

Key Words: adalimumab • granulomatous interstitial nephritis • sarcoidosis • TNF-alpha inhibitors

Received for publication April 9, 2008. Accepted for publication December 2, 2008.


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