Effective Treatment with Cyclosporine A of a Child with Systemic Lupus Erythematosus Resistant to Cyclophosphamide Pulse Therapy

Suzuki, Koichi; Tanaka, Hiroshi; Tsugawa, Koji; Ito, Eturo

doi:10.1620/tjem.208.355

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…In recent years, methotrexate, cyclosporine, and mycophenolate mofetil (MMF) have been used in therapyresistant patients, but there are not yet large randomized studies showing their efficacy and superiority to cyclophosphamide and azathioprine. [17,18,[22][23][24][25] Plasma exchange, intravenous immunoglobulins, tacrolimus, rituximab, fludarabine, cladribine, monoclonal antibodies, and rapamycin are the other therapeutic approaches used in DPLN. [5,6,14,17,22,26,27] There are also experimental therapies, such as gene therapy and stem cell transplantation, in the management of lupus nephritis.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Efficacy and Safety of Quadruple Therapy in Childhood Diffuse Proliferative Lupus Nephritis

et al. 2008

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In this study, we evaluated the frequency, clinical presentation, treatment protocols, prognostic factors, and outcome in children with diffuse proliferative lupus nephritis (DPLN). Between June 1990 and December 2004, 46 patients were diagnosed to have systemic lupus erythematosus (SLE), and 26 of them (56.5%) were found to have DPLN. Renal manifestations were present in 25 patients, and the majority of them presented with severe renal findings, such as nephrotic syndrome and renal failure. All patients were given a quadruple therapy protocol including 6-12 monthly courses of methyl prednisolone pulse therapy combined with oral prednisolone, oral cyclophosphamide, azathioprine, and dipyridamole. Nineteen of these patients were regularly followed up with a mean follow-up period of 5.9 years. Complete remission was achieved in 15 of 19 patients, and chronic renal failure developed in four patients. Renal survival rate was calculated to be 78.9% at the end of 5, 10, and 14 years. Although nephrotic range proteinuria, hypoalbuminemia, renal failure, and activity index above 12/24 at presentation seemed to be associated with poor prognosis, no significant difference could be found. Hypertension and chronicity index greater than 6/12 were found to be bad prognostic predictors. We concluded that satisfactory results were achieved with our quadruple therapy protocol; thus, more aggressive and expensive therapies can be avoided and preserved for more serious and persistent diseases.

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Section: Discussionmentioning

confidence: 99%

Long-Term Efficacy and Safety of Quadruple Therapy in Childhood Diffuse Proliferative Lupus Nephritis

et al. 2008

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“…Aragon et al [31] showed that together with MMF, Cyc A has been an alternative agent in the induction therapy in children with severe LN. There are also studies in children showing its effectiveness as a treatment option in the treatment of refractory cases of LN, but with high relapsing rates after cessation of the therapy [32,33].…”

Section: B-lymphocyte Depletion Therapymentioning

confidence: 99%

An Update on Treatment and Outcome of Lupus Nephritis in Children

Demircin¹

2013

Ann Paediatr Rheum

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“…It has been reported CsA treatment has beneficial effects in some pediatric patient with SLE resistant to conventional immunosuppressive therapy, including iv-CPA (Sakano et al, 2004;Suzuki et al, 2006). However, CsA-related nephrotoxicity, posterior reversible encephalopathy syndrome, as well as unfavorable cosmetic effects, such as hypertrichosis and gingival hypertrophy, remain major concerns for young patients with SLE, especially female adolescents.…”

Section: Tacrolimus a Calcineurin Inhibitormentioning

confidence: 99%

Treatment of Pediatric-Onset Lupus Nephritis: A New Option of Less Cytotoxic Immunosuppressive Therapy

Tanaka¹,

Imaizumi²

2011

Autoimmune Disorders - Current Concepts and Advances From Bedside to Mechanistic Insights

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Effective Treatment with Cyclosporine A of a Child with Systemic Lupus Erythematosus Resistant to Cyclophosphamide Pulse Therapy

Cited by 6 publications

References 14 publications

Long-Term Efficacy and Safety of Quadruple Therapy in Childhood Diffuse Proliferative Lupus Nephritis

Long-Term Efficacy and Safety of Quadruple Therapy in Childhood Diffuse Proliferative Lupus Nephritis

An Update on Treatment and Outcome of Lupus Nephritis in Children

Treatment of Pediatric-Onset Lupus Nephritis: A New Option of Less Cytotoxic Immunosuppressive Therapy

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