Teriflunomide
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Renal failure: case report A 45-year-old man developed renal failure during treatment with teriflunomide for relapsing-remitting multiple sclerosis. The man, whose medical history was notable for relapsing-remitting multiple sclerosis, presented with chronic renal failure and focal segmental glomerulosclerosis. His history was also significant for mild arterial hypertension, and he exhibited stable serum creatinine levels for the previous 4–5 years. In March 2016, he started receiving oral daily teriflunomide [dose not stated]. He showed stable disease without adverse reactions till May, when he developed sudden-onset marked weakness and nausea without vomiting. A clinical examination showed normal lung, abdomen and heart exams, except bland arterial hypertension and mild oedema in bilateral lowed extremities. Laboratory examinations were significant for elevated serum creatinine and urea. An urine exam showed presence of protein. Increased renal cortical echogenicity was noted on ultrasound. His liver enzymes were normal. Teriflunomide was thought to have precipitated renal failure. The man’s treatment with teriflunomide was discontinued, and he received IV hydration. His serum creatinine levels decreased over one month. His renal failure reversed following teriflunomide discontinuation. The man was re-challenged with teriflunomide in July. However, one week after re-initiation, elevated creatinine levels were noted. Hence, teriflunomide was permanently discontinued. He underwent accelerated elimination procedures to lower teriflunomide levels. A diagnosis of chronic renal failure secondary to focal segmental glomerulosclerosis, precipitated by teriflunomide was established. Dattola V, et al. Teriflunomide as precipitating factor of renal failure in a patient with relapsing-remitting multiple sclerosis and focal segmental glomerulosclerosis. Multiple Sclerosis and Related Disorders 46: Nov 2020. Available from: URL: http://doi.org/10.1016/j.msard.2020.102506 803515773
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Reactions 21 Nov 2020 No. 1831
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