Treatment of Pulmonary Hemorrhage in Childhood Systemic Lupus Erythematosus with Mycophenolate Mofetil

Samad, Ahmed S.; Lindsley, Carol B.

doi:10.1097/01.smj.0000054424.20202.7d

Cited by 28 publications

(13 citation statements)

References 15 publications

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“…restrictive lung disease combined with diaphragmatic paralysis, is a rare complication of SLE with less than 150 cases in adults and fewer than 10 cases reported in pediatrics63–64. Pulmonary hemorrhage is still linked to high mortality rates in children and adults with SLE 65.…”

Section: Cardiopulmonary and Gastrointestinal Involvementmentioning

confidence: 99%

Pediatric Lupus—Are There Differences in Presentation, Genetics, Response to Therapy, and Damage Accrual Compared with Adult Lupus?

Mina

Brunner

2010

Rheumatic Disease Clinics of North America

241

168

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Summary Some complement deficiencies predispose to SLE early in life. Currently, there are no known unique physiological or genetic pathways that can explain the variability in disease phenotypes, as is suggested by studies directly and indirectly comparing cohorts of children and adults with SLE. Children present with more acute illness and have more frequent renal, hematologic and central nervous system involvement at the time of diagnosis compared to adults with SLE. Almost all children require corticosteroids during the course of their disease, and many are treated with immunosuppressive drugs. Despite of a general lack of co-morbid conditions, mortality rates remain higher with pediatric SLE compared to aSLE. Children and adolescents accrue more damage as measured by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index, especially in the renal, ocular and musculoskeletal organ systems. Conversely, cardiovascular mortality is more prevalent in adults with SLE.

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Section: Cardiopulmonary and Gastrointestinal Involvementmentioning

confidence: 99%

Pediatric Lupus—Are There Differences in Presentation, Genetics, Response to Therapy, and Damage Accrual Compared with Adult Lupus?

Mina

Brunner

2010

Rheumatic Disease Clinics of North America

241

168

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“…The case of a 14-year old SLE patient with a severe lupus GLN, haematologic abnormalities, and diffuse alveolar hemorrhage was described by Samad et al 73 The pulmonary manifestation was resistant to many standard immunosuppressive regimens including CYF, IV pulse MPN, plasmapheresis and IVIG. Eventually, the patient was effectively treated with IV MMF at a dosage of 1 g/day.…”

Section: Pulmonary Manifestationsmentioning

confidence: 94%

Mycophenolate mofetil and systemic lupus erythematosus

Doria

Iaccarino

Arienti

et al. 2006

Lupus

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Mycophenolate mofetil (MMF) is an immunosuppressive agent which provides protection against acute transplant rejection, in patients who undergo kidney, heart and liver transplantation. Recently MMF has been used in various autoimmune conditions, including systemic lupus erythematosus (SLE). In SLE, MMF has been more extensively used in the treatment of proliferative lupus glomerulonephritis (GLN) and following the success in this field, it has also been used to control extra-renal manifestations. However, in the majority of cases MMF was administered to patients with refractory SLE manifestations and, therefore, no definite conclusion could be drawn from these experiences.In this paper, after a brief description of the mechanisms of action, the pharmacokinetics and metabolism of MMF which are relevant in SLE, and after a short discussion on the utility of performing therapeutic dose monitoring of mycphenolic acid, the experiences with the use of this drug in the different SLE manifestations were summarized and some personal data in patients with GLN were reported. Finally, the hypothetical use of MMF as a preventive strategy against the occurrence of severe manifestations in patients with mild SLE has been put forward and discussed. Lupus (2006) 15, 44-54.

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“…Recently, it has emerged as an alternative to cyclophosphamide (CYC) in the treatment of patients unresponsive to steroids and CYC, or with unacceptable toxicity secondary to these drugs [45][46][47]. As a result of various clinical trials, MMF is becoming increasingly regarded as an appropriate alternative for treatment of lupus nephritis and as maintenance therapy after CYC induction.…”

Section: Mycophenolate Mofetilmentioning

confidence: 99%

Autoimmune mechanisms in children with systemic lupus erythematosus

Stichweh

Pascual²

2005

Curr Rheumatol Rep

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Although the pathogenesis of SLE remains poorly understood, there is consensus that it involves a combination of genetic, hormonal, and environmental factors. New technologies applied to genomic and gene expression studies have revealed novel gene mutations and cytokine alterations in this disease. Recently, advances in monoclonal antibodies and recombinant DNA technology have resulted in the development of new drugs to arrest disease progression and restore physiologic immune responses without major side effects. Clinical trials to test several of these novel therapies are currently underway.

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Treatment of Pulmonary Hemorrhage in Childhood Systemic Lupus Erythematosus with Mycophenolate Mofetil

Cited by 28 publications

References 15 publications

Pediatric Lupus—Are There Differences in Presentation, Genetics, Response to Therapy, and Damage Accrual Compared with Adult Lupus?

Pediatric Lupus—Are There Differences in Presentation, Genetics, Response to Therapy, and Damage Accrual Compared with Adult Lupus?

Mycophenolate mofetil and systemic lupus erythematosus

Autoimmune mechanisms in children with systemic lupus erythematosus

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