Intermittent intravenous cyclophosphamide therapy for lupus nephritis

Lehman, Thomas J. A.; Sherry, David D.; Wagner‐Weiner, Linda; McCurdy, Deborah; Emery, Helen; Magilavy, Daniel B.; Kovalesky, Andrea

doi:10.1016/s0022-3476(89)80463-9

Cited by 115 publications

(57 citation statements)

References 20 publications

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“…In the majority of these articles I.V. CYC is used as induction treatment, with good results in the majority of patients (45)(46)(47)(48)(49)(50)(51)(52)(53). Three studies compared I.V.…”

Section: Induction Treatmentmentioning

confidence: 99%

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Groot¹,

Graeff²,

Marks³

2021

KIDNEYS

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“…In the majority of these articles I.V. CYC is used as induction treatment, with good results in the majority of patients (45)(46)(47)(48)(49)(50)(51)(52)(53). Three studies compared I.V.…”

Section: Induction Treatmentmentioning

confidence: 99%

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

Groot¹,

Graeff²,

Marks³

2021

KIDNEYS

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“…3,4,14 Sitostatik yang sering digunakan pada pengobatan nefritis lupus adalah siklofosfamid yang dapat diberikan per oral dan secara intravena dosis tinggi atau puls.…”

Section: Diskusiunclassified

Nefritis Lupus dengan Perdarahan Intrakranial pada Anak

Puspanjono¹,

Pardede²,

Trihono³

et al. 2016

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Lupus eritematosus sistemik (LES) merupakan penyakit imunologik yang mengenaibeberapa organ seperti sendi, kulit, ginjal, otak, dan organ lain. Kelainan susunan sarafpusat dapat berupa penurunan kesadaran, kejang, atau stroke. Perdarahan intrakranialjarang dilaporkan.Dilaporkan seorang anak laki-laki berumur 14 tahun, dirawat di Rumah Sakit Dr. CiptoMangunkusumo (RSCM) dengan nefritis lupus. Pada usia 9 tahun, pasien didiagnosissebagai auto-immune hemolytic anemia dan LES. Pasien diobati dengan metilprednisolonoral, tranfusi packed red cell berkala, dan terapi suportif lainnya, tetapi tidak adekuat.Lima tahun kemudian, badan pasien bengkak dan buang air kemih kemerahan. Pasiensadar, tekanan darah 140/100 mmHg, ruam kupu-kupu (-), hepatosplenomegali, edemapalpebra dan tungkai. Urinalisis: protein +3, leukosit 4-5/LPB, eritrosit 80-100/LPB.Darah: Hb 6,9 g/dl; leukosit 4600/ul, HJ 1/76/22/1, trombosit 294.000/ul; LED 30mm/jam; ureum 66 mg/dl, kreatinin 1,3 mg/dl, albumin 2,4 g/dl, kolesterol 145 mg/dl; sel LE (-), C3 26 mg/dl, C4 6 mg/dl, ANA (+), anti ds-DNA 2459 IU/ml. Biopsiginjal tidak dilakukan karena hepatosplenomegali. Pasien diberi diet nefritis, furosemid,antihipertensi, siklofosfamid puls 500 mg/m2LPB. Pasca pemberian siklofosfamid puls,tekanan darah terkontrol. Satu bulan kemudian, sewaktu hendak pemberian siklofosfamidpuls berikut, pasien menunjukkan gejala hipertensi krisis dengan tekanan darah 180/120 mmHg yang teratasi dengan nifedipin, furosemid, kaptopril, dan suportif lainnya.Ureum dan kreatinin normal. Satu hari kemudian pasien kejang tonik, sopor, tekanandarah 140/100 mmHg, pupil anisokor, paresis nervus III kanan dan nervus VI kiri,hemiparesis kanan. Pada funduskopi tampak edema papil kanan. CT scan kepalamemperlihatkan perdarahan intraserebral kanan, intraventrikuler, dan ventrikulomegali.Tindakan operatif tidak dapat dilakukan dan pasien meninggal. Kesimpulan: perdarahanintrakranial sebagai komplikasi nefritis lupus dapat disebabkan hipertensi atauvaskulopati/vaskulitis.

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“…It is most frequently used in doses of [5][6][7][8][9][10] mg/m*/week. Higher doses (up to 1 mg/kg/week, or a maximum of 50 mg/week) given intramuscularly have been beneficial for children with resistant polyarticular or systemiconset disease.…”

Section: Juvenile Rheumatoid Arthritismentioning

confidence: 99%

“…Intravenous cyclophosphamide has shown a clear benefit for children with diffuse proliferative glomerulonephritis (DPGN). Intermittent intravenous cyclophosphamide therapy has provided a good response for children with falling creatinine clearance (9).…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

“…Preservation of adequate renal function to assure growth may require earlier therapy in the child with aggressive DPGN (9). Cyclophosphamide has not been sufficiently useful for the child with membranous glomerulonephritis or prolonged significant renal compromise (creatinine clearance <30 ml/minute/l.75 m2 for more than 3 months) to justify its risks in the absence of severe "steroid toxicity."…”

Section: Systemic Lupus Erythematosusmentioning

confidence: 99%

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