Focal segmental glomerulosclerosis associated with the use of the IL-23 inhibitor guselkumab

We report a case of a 38-year-old man who developed a nephrotic syndrome shortly after the start of guselkumab for the treatment of plaque psoriasis. Renal biopsy showed focal segmental glomerulosclerosis (FSGS). The clinical course of our case is highly suspect for drug-induced FSGS since the nephrotic syndrome resolved after cessation of the drug without relapse (2 years of follow-up). To the best of our knowledge, this is the first case describing FSGS lesions associated with the use of an interleukin-23 inhibitor.

Automated summary

We present a case of nephrotic syndrome in a 38-year-old man shortly after initiation of guselkumab for plaque psoriasis treatment. Renal biopsy revealed focal segmental glomerulosclerosis (FSGS). The clinical course strongly suggests drug-induced FSGS, as the nephrotic syndrome resolved after discontinuation of the drug without relapse (2 years of follow-up). To the best of our knowledge, this is the first report of FSGS lesions associated with the use of an interleukin-23 inhibitor.