Gordon C, Jayne D, Pusey C, Adu D, Amoura Z, Aringer M, Ballerin J, Cervera R, Calvo-Alén J, Chizzolini C, Dayer Jm, Doria A, Ferrario F, Floege J, Guillevin L, Haubitz M, Hiepe F, Houssiau F, Lesavre P, Lightstone L, Meroni Pl, Meyer O, Moulin B, O'Reilly K, Praga M, Schulze-Koops H, Sinico Ra, Smith Kgc, Tincani A, Vasconcelos C, Hughes G
Rheumatology Research Group, Division of Immunity and Infection, University of Birmingham, Birmingham, UK.
Lupus. 2009 Mar;18(3):257-63. doi: 10.1177/0961203308100481.
Systemic lupus erythematosus (SLE) is a complex, multisystem autoimmune disorder, which often involves referral to multiple medical specialists. Lupus nephritis (LN) occurs in ~35% of adults with SLE and predicts poor survival. There is currently no consensus on how to manage patients with SLE or LN across specialties and across different European countries. The Lupus Nephritis Terminology Advisory Group was formed to address this issue as it impacts upon LN treatment. It has developed consensus statements based on opinions from expert panel meetings with nephrologists, nephropathologists, rheumatologists, clinical immunologists and internal medicine specialists from many European countries, after reviewing current guidelines from the European League Against Rheumatism, the American College of Rheumatology and the participants' experience. In this article, we report consensus statements that were developed in six important areas: classification of patients with LN, how classification affects the selection of treatment options and definitions of induction, response, flare and maintenance. We have also proposed a consensus for the terminology involved in the management of LN that is consistent with clinical opinion gathered from multidisciplinary expert meetings and with existing guidelines. We believe this consensus approach provides agreed expert opinion to clinicians and will form the basis for optimising LN treatment.
系统性红斑狼疮(SLE)是一种复杂的多系统自身免疫性疾病,常常需要转诊至多个医学专科。狼疮性肾炎(LN)在约35%的成年SLE患者中出现,预示着较差的生存率。目前,对于如何在不同专科以及不同欧洲国家管理SLE或LN患者尚无共识。狼疮性肾炎术语咨询小组的成立就是为了解决这一影响LN治疗的问题。该小组在回顾欧洲抗风湿病联盟、美国风湿病学会的现行指南以及参与者的经验后,基于与来自许多欧洲国家的肾脏病学家、肾病理学家、风湿病学家、临床免疫学家和内科专家的专家小组会议意见,制定了共识声明。在本文中,我们报告了在六个重要领域制定的共识声明:LN患者的分类、分类如何影响治疗方案的选择以及诱导、反应、复发和维持的定义。我们还针对LN管理中涉及的术语提出了一项共识,该共识与多学科专家会议收集的临床意见以及现有指南一致。我们相信这种共识方法为临床医生提供了一致的专家意见,并将为优化LN治疗奠定基础。