Does Tezepelumab worsen kidney function?

Hello,

Welcome to icliniq.com.

I can understand your concern.

Your concerns are correct in starting Tezspire (Tezepelumab) while having autoimmune thyroiditis and mild kidney issues. I will provide a detailed analysis below, including probable causes, necessary investigations, diagnosis, and a personalized treatment and follow-up plan for your case.

The probable causes:

1. Chronic eosinophilic airway inflammation.

2. Autoimmune dysregulation due to thyroiditis.

3. Age-related decline in renal function or autoimmune-associated nephropathy.

Investigations to be done:

1. Complete blood count (CBC) with differential (especially eosinophils).

2. Serum creatinine, BUN (blood urea nitrogen), and estimated GFR (glomerular filtration rate).

3. Urinalysis for proteinuria or sediment.

4. Thyroid function tests: TSH (thyroid-stimulating hormone), FT4 (free thyroxine), anti-TPO (thyroid peroxidase) antibodies.

5. Liver function tests (baseline before starting Tezspire).

6. Chest imaging if recent worsening of symptoms.

Differential diagnosis:

1. Severe eosinophilic asthma.

2. Autoimmune thyroiditis with systemic immune activity.

3. Early-stage chronic kidney disease.

4. Drug-induced nephropathy (if on other medications).

5. Allergic bronchopulmonary aspergillosis (if clinical suspicion exists).

Probable diagnosis:

1. Severe eosinophilic asthma in a patient with autoimmune thyroiditis and mild chronic kidney disease (likely Stage 2–3a).

Treatment plan:

1. Initiate Tezspire (Tezepelumab) after baseline labs.

2. Monitor thyroid function and renal profile regularly.

3. Continue thyroid medication (Levothyroxine) with dose adjustments as per TSH.

4. Avoid NSAIDs (non-steroidal anti-inflammatory drugs) and nephrotoxic medications.

5. Maintain good hydration.

6. Review asthma symptoms and peak flow readings monthly.

Regarding follow-up:

1. First review: two to four weeks after Tezspire initiation.

2. Then, monthly for asthma control and every three months for renal and thyroid function assessment.

3. Adjust treatment based on symptom control and lab trends.

Preventive measures:

1. Annual influenza and pneumococcal vaccination.

2. Avoid known asthma triggers.

3. Monitor for signs of adverse drug reactions or infections.

4. Regular follow-ups should be maintained for renal and thyroid monitoring.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.