Szabó Melinda Zsuzsanna, Kiss Emese
Országos Reumatológiai és Fizioterápiás Intézet Budapest, Frankel Leó út 38-40., 1023.
Orv Hetil. 2016 Aug;157(35):1385-93. doi: 10.1556/650.2016.30527.
The authors present the latest guideline for the treatment of lupus nephritis and their own single-centre results with mycofenolate mofetil treated lupus nephritis. Lupus nephritis and mainly its proliferative form is a frequent and potentially life-threatening manifestation of systemic lupus erythematosus that can lead to end-stage renal disease. The treatment of lupus nephritis greatly improved in the last decades; mycofenolate mofetil has become an alternative of cyclophosphamide both in remission induction and as a maintenance regimen as well in the treatment of Class III and IV glomerulonephritis. The authors ordered mycofenolate mofetil for 25 patients with lupus nephritis so far. Histologically most of them had Class III (A/C) or IV (A) glomerulonephritis (30-30%), and only 16% of the patients had renal impairment at that time. Mycofenolate mofetil given after glucocorticoid and cyclophosphamide induction therapy reduced the daily proteinuria from 3.18 grs to 1.06 grs. Complete remission could be achieved in 24% and partial remission in 48% of the patients. The authors conclude that mycofenolate mofetil is effective in the therapy of lupus nephritis. Orv. Hetil., 2016, 157(35), 1385-1393.
作者介绍了狼疮性肾炎的最新治疗指南以及他们使用霉酚酸酯治疗狼疮性肾炎的单中心研究结果。狼疮性肾炎,主要是其增殖性形式,是系统性红斑狼疮常见且可能危及生命的表现,可导致终末期肾病。在过去几十年中,狼疮性肾炎的治疗有了很大改善;霉酚酸酯在诱导缓解、维持治疗以及治疗Ⅲ级和Ⅳ级肾小球肾炎方面已成为环磷酰胺的替代药物。作者至今已为25例狼疮性肾炎患者开具了霉酚酸酯。组织学上,他们中的大多数患有Ⅲ级(A/C)或Ⅳ级(A)肾小球肾炎(各占30%),当时只有16%的患者有肾功能损害。在糖皮质激素和环磷酰胺诱导治疗后给予霉酚酸酯,可使每日蛋白尿从3.18克降至1.06克。24%的患者可实现完全缓解,48%的患者可实现部分缓解。作者得出结论,霉酚酸酯在狼疮性肾炎治疗中有效。《匈牙利医学周报》,2016年,157(35),1385 - 1393。