Nakajima Shoko, Umebayashi Hiroaki, Kurosawa Rumiko, Imagawa Tomoyuki, Katakura Shigeki, Mori Masaaki, Aihara Yukoh, Yokota Shumpei
Department of Pediatrics, Yokohama City University School of Medicine.
Nihon Rinsho Meneki Gakkai Kaishi. 2005 Oct;28(5):343-8. doi: 10.2177/jsci.28.343.
We reported three cases of childhood-onset male systemic lupus erythematosus (SLE), all of whom successfully treated with a combination of pulse methylprednisolone (mPSL) and pulse cyclophosphamide (IVCY). All of them had severe lupus nephritis and were complicated with other collagen diseases. Two cases were complicated with Sjögren syndrome (SS) and the other was complicated with both SS and anti-phospholipid syndrome (APS). After a combination of pulse mPSL and IVCY for a year, followed by oral predonisolone (PSL) and azathioprine (AZA), following up renal biopsy were performed in all cases, which showed histological improvement in glomerulonephritis. One case had flares a year later, but no flares were observed either in clinical symptoms or in laboratory examinations in the others. Their autoantibodies except anti-nuclear antibody (ANA) were eliminated. We suggest a combination of pulse mPSL and IVCY is effective for the patients who are suffering with severe lupus nephritis complicated with the other collagen diseases.
我们报告了3例儿童期起病的男性系统性红斑狼疮(SLE)患者,均采用甲泼尼龙冲击疗法(mPSL)联合环磷酰胺冲击疗法(IVCY)成功治疗。他们均患有严重的狼疮性肾炎,并合并其他胶原病。2例合并干燥综合征(SS),另1例合并SS和抗磷脂综合征(APS)。在mPSL和IVCY联合治疗1年后,继以口服泼尼松龙(PSL)和硫唑嘌呤(AZA),所有病例均进行了随访肾活检,结果显示肾小球肾炎组织学改善。1例在1年后病情复发,但其他病例在临床症状和实验室检查中均未观察到复发。除抗核抗体(ANA)外,他们的自身抗体均消失。我们认为mPSL和IVCY联合疗法对患有严重狼疮性肾炎并合并其他胶原病的患者有效。