Department of Nephrology and Rheumatology, Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan.
Am J Kidney Dis. 2010 Feb;55(2):344-7. doi: 10.1053/j.ajkd.2009.06.012. Epub 2009 Jul 23.
Lupus nephritis is a major manifestation of systemic lupus erythematosus. Treatment with such immunosuppressive agents as corticosteroids or cyclophosphamide can decrease the progression of lupus nephritis; however, these agents have potentially severe adverse reactions. Therefore, the development of new drugs with fewer side effects is needed. Here, we report 2 patients with lupus that were treated successfully with retinoids. Initially, both patients were treated with 60 mg/d of prednisolone. However, nephrotic syndrome was not improved. Subsequently, treatment with 10 mg/d of all-trans-retinoic acid was started orally and elicited a good response, showing a decrease in proteinuria. Although additional controlled clinical studies are needed to confirm these findings, we suggest that therapy using retinoids may represent a novel approach to the treatment of patients with lupus nephritis.
狼疮性肾炎是系统性红斑狼疮的主要表现之一。使用皮质类固醇或环磷酰胺等免疫抑制剂治疗可以减缓狼疮性肾炎的进展;然而,这些药物有潜在的严重不良反应。因此,需要开发副作用更少的新药。在这里,我们报告了 2 例用维 A 酸成功治疗的狼疮患者。最初,这两名患者均接受 60 毫克/天的泼尼松龙治疗。然而,肾病综合征并未改善。随后,开始口服 10 毫克/天的全反式维 A 酸治疗,取得了良好的反应,蛋白尿减少。尽管需要进行更多的对照临床试验来证实这些发现,但我们建议使用维 A 酸治疗可能代表治疗狼疮性肾炎患者的一种新方法。