A 35-year-old male diagnosed with HLA B27 positive ankylosing spondylitis in 2011.
An abdominal ultrasound showed multiple hepatic and renal cysts.
Right kidney of 18cm and left kidney of 19cm.
Having no family history of cystic diseases, she is diagnosed with polycystic disease due to de novo mutation.
In March 2011, she started treatment with adalimumab (Humira®) 40mg every 15 days.
At this time the patient has: haemoglobin (Hb) 12.4g/dl, creatinine (Cr) 2.3mg/ml, estimated glomerular proteinuria (GFR) 1.73min MDRD (Modification of Diet in Renal Disease) 1024mg.
Treatment was suspended in January 2012 due to the development of polyneuropathy and purpura.
In February 2012 a nuclear magnetic resonance (NMR) showed a right kidney of 18cm (volume of 2450ml) and left kidney of 18cm (2250ml).
In April 2012, Golimumab (Simponi®) 50mg was started every five weeks.
Six doses were administered and suspended in September 2012, when the patient reported a remarkable increase in abdominal diameter and umbilical hernia that is directly related to the administration of the drug.
A last dose is given in December 2012.
In March 2013, a new MRI showed a right kidney of 25.4cm with a volume of 3899ml and left kidney of 24.1cm with a volume of 2739ml and a slight increase in much smaller amount of liver cysts.
