Shen Y, Yuan J, Chen S, Zhang YF, Yin L, Hong Q, Zha Y. Combination treatment with telitacicept, mycophenolate mofetil and glucocorticoids for immunoglobulin A nephropathy: A case report. World J Clin Cases 2024; 12(29): 6307-6313 [PMID: 39417050 DOI: 10.12998/wjcc.v12.i29.6307]
Corresponding Author of This Article
Yan Zha, MD, Chief Physician, Department of Nephrology, Guizhou Provincial People's Hospital, Baoshan South Road, Nanming District, Guiyang 550002, Guizhou Province, China. bookworm2023@163.com
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2024; 12(29): 6307-6313 Published online Oct 16, 2024. doi: 10.12998/wjcc.v12.i29.6307
Combination treatment with telitacicept, mycophenolate mofetil and glucocorticoids for immunoglobulin A nephropathy: A case report
Yan Shen, Jin Yuan, Shuang Chen, Yong-Feng Zhang, Ling Yin, Qin Hong, Yan Zha
Yan Shen, Jin Yuan, Shuang Chen, Yong-Feng Zhang, Ling Yin, Qin Hong, Yan Zha, Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China
Author contributions: Shen Y contribute to patient management, manuscript writing; Yuan J contribute to clinical treatment of the patient; Chen S contribute to data analysis and interpretation; Zhang YF and Yin L contribute to Collection of experimental data from the patient; Hong Q contribute to analysis and interpretation of pathological images; Zha Y contribute to research design and conceptualization, including formulating the research question and designing the study.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Zha, MD, Chief Physician, Department of Nephrology, Guizhou Provincial People's Hospital, Baoshan South Road, Nanming District, Guiyang 550002, Guizhou Province, China. bookworm2023@163.com
Received: May 3, 2024 Revised: June 4, 2024 Accepted: August 1, 2024 Published online: October 16, 2024 Processing time: 117 Days and 14.5 Hours
Abstract
BACKGROUND
Telitacicept reduces B cell activation and abnormal immunoglobulin A (IgA) antibody production by inhibiting the activity of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL), thereby decreasing IgA deposition in the glomeruli and local inflammatory response. This ultimately protects the kidneys from damage. This mechanism suggests that Telitacicept has potential efficacy in the treatment of IgA nephropathy.
CASE SUMMARY
We present the case of a 24-year-old female who was diagnosed with IgA nephropathy due to significant proteinuria and mild renal impairment. Pathologically, she exhibited focal proliferative glomerulonephritis. Treatment with angiotensin II receptor blocker, hormones, and mycophenolate mofetil did not lead to a significant improvement in her condition. However, upon the addition of telitacicept, the patient’s renal function recovered and her proteinuria rapidly reduced. Hormones were swiftly tapered and discontinued, with no occurrence of severe infections or related complications.
CONCLUSION
Telitacicept combined with hormones and mycophenolate mofetil may be a safe and effective induction therapy for IgA nephropathy.
Core Tip: Telitacicept reduces B cell activation and abnormal immunoglobulin A (IgA) antibody production by inhibiting the activity of B lymphocyte stimulator and a proliferation-inducing ligand, thereby decreasing IgA deposition in the glomeruli and local inflammatory response. This mechanism suggests that Telitacicept has potential efficacy in the treatment of IgA nephropathy. This paper reports a successful clinical case of using Telitacetin to treat IgA nephropathy.
