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Nephrotic-range proteinuria and membranoproliferative glomerulonephritis-like pattern caused by interferon-β1b in a patient with multiple sclerosis

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Abstract

Interferon-beta (IFN-β) subtypes are widely used as immunomodulatory agents for relapsing–remitting multiple sclerosis (MS). Although generally well tolerated, a growing number of reports have recently shown association of long-term IFN-β therapy with several types of glomerulonephritis. Here, we present the case of a 42-year-old woman with MS who developed nephrotic-range proteinuria after taking IFN-β1b for nine years. Initially, due to the presence of histological features consistent with immunoglobulin A (IgA) nephropathy (granular IgA deposits in mesangial lesions), a tonsillectomy plus steroid pulse therapy was performed. However, proteinuria did not significantly decrease after these treatments. Therefore, a second renal biopsy was performed after three years, revealing a membranoproliferative glomerulonephritis-like pattern without immune complex. Further immunofluorescence analysis showed attenuated IgA staining. Consequently, IFN-β1b was replaced with dimethyl fumarate, resulting in complete remission, with proteinuria decreasing to the level of 0.2 g/day. Although it is a rare adverse effect, physicians should pay careful attention to the symptoms and findings of nephritis during the follow-up of patients under treatment with this agent.

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Authors and Affiliations

  1. Department of Nephrology, National Hospital Organization Higashihiroshima Medical Center, Higashi-Hiroshima, Japan

    Taisuke Irifuku & Kosuke Okimoto

  2. Department of Diagnostic Pathology, Otsu City Hospital, Otsu, Japan

    Naoko Masuzawa

  3. Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan

    Takao Masaki

Authors
  1. Taisuke Irifuku
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  2. Kosuke Okimoto
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  3. Naoko Masuzawa
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  4. Takao Masaki
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Correspondence to Taisuke Irifuku.

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Informed consent was obtained from the patient whose case in reported in this paper.

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Irifuku, T., Okimoto, K., Masuzawa, N. et al. Nephrotic-range proteinuria and membranoproliferative glomerulonephritis-like pattern caused by interferon-β1b in a patient with multiple sclerosis. CEN Case Rep 12, 275–280 (2023). https://doi.org/10.1007/s13730-022-00745-8

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  • DOI: https://doi.org/10.1007/s13730-022-00745-8

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