POS-463 IMMUNE-COMPLEX-MEDIATED MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS SECONDARY TO ANKYLOSING SPONDYLITIS : CASE REPORT AND A BRIEF LITERATURE REVI1EW OF THE RENAL INVOLVEMENT IN ANKYLOSING SPONDYLITIS

Abstract

Ankylosing Spondylitis is a chronic inflammatory disease primarily affecting the joints, that can be associated with several extra-articular consequences. Among these, renal involvement remainsrare but significant, as it is associated with poor prognosis. To help further characterize this involvement, we report a new associated renal pattern. A 22-year-old Moroccan woman with a history of inflammatory lower back pain, buttock pain and bilateral knee and ankle arthritis, presented in our department with a nephrotic syndrome. A renal biopsy showed an Immune-complex-mediated membranoproliferative glomerulonephritis. Further testing in search for an etiology to explain her presentation, revealed that the patient was HLA-B27 positive and using the Assessment of Spondylarthritis International Society (ASAS) criteria, the diagnosis of Ankylosing Spondylitis was retained. The patient was put under Adalimumab, which resulted in marked improvement of her arthralgias and her proteinuria, and a disappearance of her nephrotic syndrome. We are reporting in this paper the first known association of immune-complex-mediated glomerulonephritis and Ankylosing spondylitis. This case report adds to the myriad of renal pathologic patterns that are described in association to this chronic inflammatory autoimmune disease, offering new information that would help shed further light on the pathophysiology of these disorders.