IgA Nephropathy in the Setting of Anti-TNF-α Therapy for Inflammatory Bowel Disease

Tumor necrosis factor-alpha (TNF-alpha)-inhibiting agents are a standard therapy for moderate-to-severe inflammatory bowel disease (IBD). IgA nephropathy in the setting of prolonged exposure to TNF-alpha inhibitors is a rare, clinically significant adverse event often overlooked by gastroenterologists but well documented in the rheumatologic literature. We present a case series of 3 patients with IBD on TNF-alpha inhibitors who developed biopsy-proven IgA nephropathy. Clinicians prescribing TNF-alpha inhibitors to patients with IBD need to be aware of this potential side effect. Therapies with alternative mechanisms of action should instead be considered.