Combination therapy for rheumatoid arthritis and drug-induced systemic lupus erythematosus

1994 ◽  
Vol 13 (3) ◽  
pp. 522-524 ◽  
Author(s):  
A. A. Borg ◽  
M. J. Davis ◽  
P. T. Dawes ◽  
M. F. Shadforth
Lupus ◽  
2012 ◽  
Vol 21 (9) ◽  
pp. 1003-1006 ◽  
Author(s):  
K Maeshima ◽  
K Ishii ◽  
M Torigoe ◽  
C Imada ◽  
M Iwakura ◽  
...  

We report a 37-year-old female of intractable rheumatoid arthritis (RA) complicated by systemic lupus erythematosus (SLE), who was successfully treated with a combination of tocilizumab (TCZ) and tacrolimus. She was diagnosed with RA when she was 21 years old, and was administered oral prednisolone, injectable gold and salazosulfapyridine, but deformity of her hands gradually developed. She developed high fever and thrombocytopenia when she was 35 years old. Renal involvement, pericarditis, positive antinuclear antibody and high level of anti-double-stranded DNA antibody were found and the patient was diagnosed with SLE. Polyarthritis and immunological abnormalities developed despite aggressive immunosuppressive therapy including high-dose corticosteroids and intravenously administered cyclophosphamide. Tacrolimus (TAC) therapy gave only partial improvement of joint symptoms. After the initiation of combination therapy with TCZ, not only was a complete remission of RA obtained, but also the serum levels of SLE markers dramatically decreased. Our report suggests the possibility that this combination therapy is effective in treating SLE as well as RA.


PEDIATRICS ◽  
1967 ◽  
Vol 40 (5) ◽  
pp. 822-827
Author(s):  
Wolfgang W. Hagge ◽  
Edmund C. Burke ◽  
Gunnar B. Stickler

The clinical course of 41 patients who had systemic lupus erythematosus complicated by nephritis with symptoms beginning before they were 15 years old was reviewed. The retrospective analysis showed a definite trend toward prolonged survival among the patients receiving high doses of steroids, compared to those receiving no or low doses. We conclude that it is no longer justified to withhold high-dose steroid therapy from children with lupus nephritis, but it should be emphasized equally that this does not apply to children with discoid lupus erythematosus, rheumatoid arthritis with a positive LE clot test, or drug-induced lupus erythematosus. Our present plan of management is outlined.


PEDIATRICS ◽  
1969 ◽  
Vol 43 (3) ◽  
pp. 472-473
Author(s):  
G. B. Stickler ◽  
E. C. Burke

The article, "Systemic Lupus Erythematosus in Childhood," by Drs. Meislin and Rothfield raises a number of questions because our group recently published our experience with this disease. The authors failed to define precisely what they mean by "systemic lupus erythematosus." We note that 10% of their patients had a negative LE clot test, and apparently patients with drug-induced lupus erythematosus were included. Furthermore, it is not possible to ascertain whether or not their group includes children with the clinical picture of degenerative rheumatoid arthritis with a positive LE clot test and absence of renal involvement.


2020 ◽  
Vol 8 ◽  
pp. 2050313X2091002 ◽  
Author(s):  
Umut Selamet ◽  
Ramy M Hanna ◽  
Anthony Sisk ◽  
Lama Abdelnour ◽  
Lena Ghobry ◽  
...  

Drug-induced lupus erythematosus has features distinct from primary systemic lupus erythematosus. It can occur with a wide variety of agents that result in the generation of anti-histone or other types of antibodies. Systemic manifestations of drug-induced systemic lupus erythematosus may include renal dysfunction due to circulating immune complexes or due to other immune reactions to the culprit medication(s). Acute interstitial nephritis occurs due to DNA–drug or protein–drug complexes that trigger an allergic immune response. We report a patient who developed acute kidney injury, rash, and drug-induced systemic lupus diagnosed by serologies after starting chlorthalidone and amiodarone. A renal biopsy showed acute interstitial nephritis and not lupus-induced glomerulonephritis. It is important to note that systemic lupus erythematosus and acute interstitial nephritis can occur together, and this report highlights the role of the kidney biopsy in ascertaining the pathological diagnosis and outlining therapy in drug-induced lupus erythematosus.


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