Nephrology Center and Department of Rheumatology, Toranomon Hospital, Japan.
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan.
Intern Med. 2023 Apr 1;62(7):1037-1041. doi: 10.2169/internalmedicine.0160-22. Epub 2022 Sep 6.
Systemic lupus erythematosus was diagnosed in a patient at 43 years old. When proteinuria recurred at 57 years old, the first kidney biopsy was performed, and class IV-G (A) +V lupus nephritis was diagnosed. The prednisolone dose was increased to 40 mg/day, and cyclosporine A was introduced. After 1 year, proteinuria had decreased to 0.1 g/day. Prednisolone was discontinued three years later, and cyclosporine A was continued. Thereafter, proteinuria did not reoccur. At 67 years old, a second kidney biopsy showed complete remission of lupus nephritis. Cyclosporine A enabled permanent discontinuation of glucocorticoids in a patient with lupus nephritis.
系统性红斑狼疮于患者 43 岁时确诊。57 岁时蛋白尿再次出现，进行首次肾活检，诊断为狼疮肾炎 4 型-G（A）+V 型。泼尼松龙剂量增至 40mg/天，并引入环孢素 A。1 年后，蛋白尿减少至 0.1g/天。3 年后停用泼尼松龙，继续使用环孢素 A。此后，蛋白尿未再出现。67 岁时，进行第二次肾活检显示狼疮肾炎完全缓解。环孢素 A 使狼疮肾炎患者能够永久停用糖皮质激素。
