[Treatment of diffuse glomerulonephritis in systemic lupus erythematosus with a combination of anticoagulants, corticosteroids and immunosuppressors].

The results from the combined treatment with anticoagulants (heparin and acenocoumarol), corticosteroids and immunosuppressors are reported in 27 patients with diffuse lupus glomerulonephritis. In 14 patients (51,9%) complete clinical-laboratory remission was obtained, and in 9 patients (33,3%)--partial. Two patients (7,4%) deteriorated and one female of them--died. Two patients (7,4%) died from the complications in connection with the treatment. The following conditions are necessary for the attainment of favourable therapeutic effect: intravenous administration of 30 000 U heparin for at least 60 days; high initial dose of corticosteroids (60 mg prednisolone) in the course of 2-3 months or initiation with "pulse" methylprednisolone treatment (300 mg methylprednisolone intravenously for 3 to 5 days), when a shortening of the periods with the high initial doses to 1-2 months is possible; considerable duration of the treatment as a whole--at least I and 1/2 year; qualitative follow up care. With alternating intake of corticosteroids--the dose for two days, taken as a single dose every second day--reduces sharply the incidence and severity of the adverse effects, induced by them, but with no effect on therapeutic outcome.