[Combined use of impact doses of 6-methylprednisolone and cyclophosphamide in patients with systemic lupus erythematosus].

The priming doses of 6-methylprednisolone (6-MP) and cyclophosphamide (pulse therapy) were used for the treatment of 23 patients with SLE associated with primary involvement of the kidneys and pronounced immunologic disorders. The effect of combined therapy was evaluated on the extrarenal manifestations of SLE, proteinuria, hematuria, glomerular filtration, creatinine, antibodies to native DNA (anti-nDNA), complement, cryoprecipitins, antinuclear factor, and circulating immune complexes (CIC). The treatment efficacy was evaluated on day 4 since the beginning of the treatment and on the patients' discharge from hospital. The data obtained point to a significant increase of glomerular filtration and complement level, a reduction in CIC and anti-nDNA and cryoprecipitins within the first day after discontinuation of the treatment. The diminution of proteinuria and improvement of the urinary sediment were seen in over 50% of the patients. Variation of the laboratory findings correlated well with the improvement of the disease clinical picture. The combination of the priming doses of 6-MP and cyclophosphamide holds promise in the treatment of patients with associated SLE and grave renal involvement, marked immunologic disorders and generalized autoimmune vasculitis.