scholarly journals Mycophenolate Mofetil for a Flare Child Lupus Nephritis: A Case Reports

2021 ◽  
Vol 2 (2) ◽  
pp. 112-117
Author(s):  
Gina Puspita ◽  
Desy Rusmawatiningtyas ◽  
Sumadiono
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Case Reports ◽  
Renal Involvement ◽  
High Dose ◽  
High Dose Corticosteroid ◽  
Steroid Dose ◽  
High Doses ◽  
Dose Corticosteroid

Renal involvement is the most common complication of systemic lupus erythematosus(SLE) and is also an important predictor of patient mortality. The incidence of flaresis estimated at 65% each year in patients with lupus nephritis. Therapy in lupusnephritis with flare also uses high doses of steroid agents and strongimmunosuppression agent. Mycophenolate mofetil (MMF) as a immunosuppressionagent tends to favor for flare in lupus nephritis. We describe a patient who had flarein lupus nephritis that resolved with high-dose steroid and MMF. The combination ofimmunosuppression agent and high-dose corticosteroid is an effective for control ofactive diseases. Cyclophosphamide as the steroid sparing agent was discontinuedbecause of adverse effect as well as hematuria. Partial remission was later achievedand maintained with MMF and corticosteroid after five month with protocol treatment.Thus, MMF while maintaining the steroid dose may induce remission for this case.

Mycophenolate Mofetil for a Flare Child Lupus Nephritis: A Case Reports

2021 ◽  
Vol 2 (1) ◽  
pp. 113-118
Author(s):  
Gina Puspita ◽  
Desy Rusmawatiningtyas ◽  
Sumadiono
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Case Reports ◽  
High Dose ◽  
Common Complication ◽  
High Dose Corticosteroid ◽  
Steroid Dose ◽  
High Doses ◽  
Dose Corticosteroid

A B S T R A C TRenal involvement is the most common complication of systemic lupus erythematosus(SLE) and is also an important predictor of patient mortality. The incidence of flaresis estimated at 65% each year in patients with lupus nephritis. Therapy in lupusnephritis with flare also uses high doses of steroid agents and strongimmunosuppression agent. Mycophenolate mofetil (MMF) as a immunosuppressionagent tends to favor for flare in lupus nephritis. We describe a patient who had flarein lupus nephritis that resolved with high-dose steroid and MMF. The combination ofimmunosuppression agent and high-dose corticosteroid is an effective for control ofactive diseases. Cyclophosphamide as the steroid sparing agent was discontinuedbecause of adverse effect as well as hematuria. Partial remission was later achievedand maintained with MMF and corticosteroid after five month with protocol treatment.Thus, MMF while maintaining the steroid dose may induce remission for this case.

Myelofibrosis and Systemic Lupus erythematosus: Reversal of Fibrosis with High-Dose Corticosteroid Therapy

1992 ◽  
Vol 88 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Yasushi Inoue ◽  
Atsushi Matsubara ◽  
Shigeru Okuya ◽  
Koichiro Okafuji ◽  
Kohei Kaku ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Corticosteroid Therapy ◽  
Lupus Erythematosus ◽  
High Dose ◽  
Systemic Lupus ◽  
High Dose Corticosteroid ◽  
Dose Corticosteroid

scholarly journals Primary central nervous system lymphoma in a patient with neuropsychiatric systemic lupus erythematosus receiving mycophenolate mofetil: A case report and literature review

2021 ◽  
Author(s):  
Toru Sakairi ◽  
Masao Nakasatomi ◽  
Mitsuharu Watanabe ◽  
Hiroko Hamatani ◽  
Hidekazu Ikeuchi ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Remission Induction ◽  
High Dose ◽  
Systemic Lupus ◽  
The Brain

ABSTRACT A 41-year-old woman with a 14-month history of systemic lupus erythematosus (SLE) presented with headache, aphasia, and agraphia. A laboratory examination revealed mild proteinuria, hypocomplementemia, and elevated anti-double-stranded DNA antibody levels. A cerebrospinal fluid analysis demonstrated elevated protein and interleukin-6 levels. Magnetic resonance imaging (MRI) of the brain identified multiple lesions suggestive of brain edemas and small haemorrhages. She was diagnosed as having neuropsychiatric lupus and lupus nephritis and received remission induction therapy with high-dose corticosteroid and intravenous cyclophosphamide. She achieved a complete remission, and treatment with mycophenolate mofetil (MMF) was initiated 3 months thereafter for remission maintenance. At 13 months after the exacerbation of SLE, she complained of headache and nausea. A gadolinium-enhanced MRI of the brain revealed a low-signal-intensity tumour with marginal ring enhancement of 50 mm in the left frontal lobe. The tumour was excised, and the histological diagnosis was diffuse large B-cell lymphoma with positive Epstein–Barr virus (EBV). MMF was discontinued. Remission induction therapy with rituximab, high-dose methotrexate, procarbazine, and vincristine was administered, and she achieved remission. Previous reports suggest that use of MMF is associated with primary central nervous system (CNS) lymphoma (PCNSL) in patients with lupus nephritis or other autoimmune diseases or in post-transplant patients. Our observation that PCNSL occurred after CNS involvement of SLE suggests that EBV and CNS inflammation arising from SLE might have contributed to the development of PCNSL.

Remission of the Renal Involvement in a Patient with Primary Sjo¨gren’s Syndrome (SS) after Pulse High-Dose Corticosteroid Infusion Therapy

2001 ◽  
Vol 20 (3) ◽  
pp. 225-228 ◽  
Author(s):  
Y. Saeki ◽  
S. Ohshima ◽  
T. Ishida ◽  
Y. Shima ◽  
M. Umeshita-Sasai ◽  
...  
Keyword(s):  
Renal Involvement ◽  
Infusion Therapy ◽  
High Dose ◽  
High Dose Corticosteroid ◽  
Dose Corticosteroid

scholarly journals Efficacy of High-Dose Mycophenolate Mofetil in Multitarget Therapy for Lupus Nephritis: Two Consecutive Case Reports

Cureus ◽  
2020 ◽  
Author(s):  
Yoshitaka Furuto ◽  
Mariko Kawamura ◽  
Akio Namikawa ◽  
Hiroko Takahashi ◽  
Yuko Shibuya
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Case Reports ◽  
High Dose ◽  
Consecutive Case ◽  
Multitarget Therapy

Comparison of standard of care treatment with a low steroid and mycophenolate mofetil regimen for lupus nephritis in the ALMS and AURA studies

Lupus ◽  
2019 ◽  
Vol 28 (5) ◽  
pp. 591-596
Author(s):  
M Dall’Era ◽  
N Solomons ◽  
R Federico ◽  
M Truman
Keyword(s):  
Mycophenolate Mofetil ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Dose Regimen ◽  
Standard Of Care ◽  
High Dose ◽  
Double Blind ◽  
Term Outcome ◽  
Long Term Outcome

Lupus nephritis is the most common organ-threatening manifestation of systemic lupus erythematosus. The current standard of care for patients is treatment with a combination of steroids plus either mycophenolate mofetil (MMF) or cyclophosphamide. However, these medications are associated with considerable toxicity and suboptimal efficacy. This retrospective propensity analysis of data from 63 matched patients enrolled in two of the largest active lupus nephritis controlled trials, ALMS and AURA, suggests that the high dose regimen of MMF and steroids as described in the 2012 American College of Rheumatology lupus nephritis guidelines may not be necessary in all lupus nephritis patients. A lower dose regimen may result in better long-term safety, including a reduction in lymphoproliferative disorders, skin cancers and steroid related side effects, without compromising efficacy. An ongoing randomized controlled double-blind phase 3 study, AURORA (NCT03021499), is investigating renal response in 358 patients randomized to receive a low dose regimen containing voclosporin, MMF and steroid therapy as used in the AURA trial. It is anticipated that the AURORA study and its blinded two-year extension will provide important long-term outcome data.

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