Improvement of renal function and disappearance of hepatitis B virus DNA in a patient with rheumatoid arthritis and renal amyloidosis following treatment with infliximab

✍ Scribed by Maria Grazia Anelli; Diletta Domenica Torres; Carlo Manno; Crescenzio Scioscia; Florenzo Iannone; Michele Covelli; Francesco Paolo Schena; Giovanni Lapadula

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 38 KB
• Volume: 52
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.21216

✦ Synopsis

Reactive systemic AA amyloidosis is a severe complication of rheumatoid arthritis (RA), occurring in 2-5% of RA patients (1). Infliximab, a monoclonal antibody against tumor necrosis factor ␣ (TNF␣), is successfully used in the treatment of RA (2). TNF␣ plays a key role in inducing the synthesis of the hepatic acute-phase reactant protein serum amyloid A, the precursor of tissue AA amyloid.

There have been reports of TNF␣ blockade treatment in patients with rheumatic diseases complicated by renal AA amyloidosis (3,4). The major concern with infliximab is the possible increase of infections, and no established data have been presented on the safety of infliximab in patients with hepatitis B virus (HBV) infection. This report describes the case of a patient with RA, renal amyloidosis, and HBV-related chronic hepatitis in whom infliximab improved renal function with the disappearance of HBV replication.