Nephrotic syndrome as a complication of anti-TNFin a patient with rheumatoid arthritis

We describe a patient with rheumatoid arthritis (RA) who developed a nephrotic syndrome during treatment with a fully human recombinant monoclonal antibody against TNF� (adalimumab, Humira, Abbott). The proteinuria disappeared spontaneously after cessation of anti-TNF� treatment and relapsed after rechallenge, pointing to