First author: S Alehashemi
Journal : Arthritis and Rheumatology
Reference : DOI : 10.1002/art.42664
Link to article: https://pubmed.ncbi.nlm.nih.gov/37488949/
This article reports the first case of iatrogenic systemic amyloidosis due to prolonged use of anakinra, an interleukin-1 receptor antagonist (IL-1Ra), in a patient suffering from multisystem inflammatory disease of neonatal onset (NOMID).
After several years of treatment with daily injections, the patient developed nodules at the injection site, a nephrotic syndrome and amyloid deposits in various organs (skin, kidney, stomach). Mass spectrometry analysis identified these deposits as being due to recombinant anakinra protein, distinct from the endogenous version.
This case highlights a rare complication of injectable biologic treatments, exacerbated by high and prolonged doses. It highlights the importance of monitoring serum protein levels, varying injection sites, and considering a change of therapy if anakinra-related amyloidosis is diagnosed.
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