Makati Medical Center Department of Medicine Medical Grandrounds July 12, 2007 8:15Am, Ledesma Hall. Marizen L. Lim, Md. Learning Objectives. To present a case of SLE with lupus nephrtis To present updates on the treatment of lupus nephritis. Idenifying Data. ER 43-y/0 female
3x spontaneous abortions
RenalRPGNImmune Complex GN
Postrenal Low C3 Normal C3
Post infectious Lupus nephritis
estimated crea clearance: 29.48 ml/min
Clinically diagnosed Systemic Lupus Erythematosus (SLE) with proteinuria
Lupus Nephritis Class III
Hct: 27.4 ↓
anti-DNA: (+) anti-SSA(Ro): (+)
anti-Sm: (+) anti-SSB(La): (+)
anti-RNP: (-) anti-Jo1: (-)
CYC 700mg in D5W 500cc x 2 hours
Pulse steroids: How much is enough? Giovanni Franchin, and Betty Diamond Columbia University, Department of Medicine, Division of Rheumatology, 1130 St. Nicholas Ave., Audubon III Room 923, New York, NY 10032, USA Available online 29 August 2005.
Cyclophosphamide 1gm/m2 every month for 6 months (Induction phase)
Cyclophosphamide 1gm/m2 every 3 months for 2 years (Maintainance phase)
Long-term efficacy of azathioprine treatment for proliferative lupus nephritis
H. C. NossentandW. Koldingsnes Department of Rheumatology, University Hospital Tromsø, Norway
The Lupus Nephritis Collaborative Study: A randomized, controlled, multicenter clinical trial (John M. Lachin, Sc.D.)
Long-Term Study of MycophenolateMofetil as Continuous Induction and Maintenance Treatment for Diffuse Proliferative Lupus Nephritis (Tak-Mao Chan, et al; Feb. 23,2005)
RESULTS: >90% in each group responded favorably (complete or partial remission)to induction treatment.
Both the relapse-free survival and the hazard ratio for relapsewere similar between MMF- and CTX-AZA–treated patients(11 and nine patients relapsed, respectively) and between thosewith MMF treatment for 12 or 24 mo.
CONCLUSION: MMF and prednisolone constitute an effectivecontinuous induction-maintenance treatment for DPLN in Chinesepatients.