Ms Yi Zhang1, Ms Hui Xu1
1Xiangya Hospital of Central South University, Changsha, China
Biography:
A postgraduate from Xiangya Hospital, Central South University, I work under the guidance of Prof. Xu Hui, Chief of Nephrology Department, with research emphasis on IgA-associated disorders.
Abstract:
Introduction
Psoriasis is a chronic inflammatory systemic disease that often co-occurs with glomerular diseases, such as IgA nephropathy (IgAN), characterized by mesangial IgA deposition, hematuria, and proteinuria. Treating both conditions poses a dilemma, as budesonide for IgAN is a corticosteroid that may worsen psoriasis.
Case report:
A 45-year-old woman with plaque psoriasis was diagnosed with Lee Stage II IgAN in 2024, with 24-hour urine protein 2g, UPCR 1.12g/g, and normal serum creatinine. She received subcutaneous telitacicept (160mg/week initially, adjusted later) and oral losartan potassium. After 5 months, urine protein was trace, UPCR 0.2g/g; one-year follow-up showed complete renal remission (UPCR 0.15g/g, normal creatinine) and relieved rash.
Discussion and Conclusion:
Psoriasis and IgAN share an abnormality in the Th17/IL-17 axis. Telitacicept targets BLyS/APRIL, inhibits B-cell maturation, reduces Th17 cells and pro-inflammatory cytokines, and lowers Gd-IgA1. This case confirms telitacicept’s efficacy and safety for concurrent psoriasis and IgAN, offering a viable therapeutic option.