Camous Laurent, Melander Catherine, Vallet Marion, Squalli Tarek, Knebelmann Bertrand, Noël Laure-Hélène, Fakhouri Fadi
Department of Nephrology, Université Paris V-René Descartes, APHP, Hôpital Necker-Enfants Malades, Paris, France.
Am J Kidney Dis. 2008 Aug;52(2):346-52. doi: 10.1053/j.ajkd.2008.03.036. Epub 2008 Jun 24.
Lupus nephritis (LN) is a severe and frequent complication of systemic lupus erythematosus. For decades, cyclophosphamide-based regimens have been the gold standard in treating patients with LN. However, cyclophosphamide use is associated with increased morbidity and mortality, and thus alternative treatments are needed. We report 3 cases of severe class IV LN successfully treated with rituximab as an induction, as well as a long-term maintenance, treatment. Complete remission of LN, documented by means of a control kidney biopsy, occurred in all patients and was maintained during follow-up using rituximab as sole maintenance treatment. No severe infectious complications were observed during treatment with rituximab. Our data suggest that rituximab may prove to be an optimal maintenance treatment in patients with severe LN.
狼疮性肾炎（LN）是系统性红斑狼疮严重且常见的并发症。几十年来，基于环磷酰胺的治疗方案一直是治疗LN患者的金标准。然而，使用环磷酰胺会增加发病率和死亡率，因此需要其他替代治疗方法。我们报告了3例严重IV级LN患者，使用利妥昔单抗进行诱导治疗以及长期维持治疗，均取得成功。通过对照肾活检记录，所有患者的LN均完全缓解，并在随访期间使用利妥昔单抗作为唯一维持治疗得以维持。在使用利妥昔单抗治疗期间未观察到严重感染并发症。我们的数据表明，利妥昔单抗可能被证明是严重LN患者的最佳维持治疗药物。
