Rescue therapy in lupus nephritis patients with micophenolato mofetil
Long term cyclophosfamide combinated steroids therapy improves renal survival in patients with Proliferate Lupus Nephritis, with considerable toxic effects. In lately years MM?, a irnmune suppressor used in transplant, seems lo be effective in selected cases of Lupus Ne...
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2019
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/26453 |
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I10-R10-article-264532020-02-28T20:58:09Z Rescue therapy in lupus nephritis patients with micophenolato mofetil Terapia de rescate con micofenolato mofetil en pacientes con nefritis lúpica Prettini, Viviana B Gastón F, Avila López Sesín, Ana M Dotto, Beatríz H Sanchez Freytes, Marcelo Sesín, Jorge Vergottini, Juan C micofenolato mofetil lupus nephritis rescue treatment . Long term cyclophosfamide combinated steroids therapy improves renal survival in patients with Proliferate Lupus Nephritis, with considerable toxic effects. In lately years MM?, a irnmune suppressor used in transplant, seems lo be effective in selected cases of Lupus Nephritis. Methods We will describe six patients with Lupus Nephritis class IV and V (OMS Classification), that what different causes they must be treated with MM? like rescue drug. This stabilizes the renal funetion, controls LES activity and allows reductions or end of corticoids. Results In tree cases we achievement total remission, two show partial remission and we had a fail because plaquetopenia and severe leucopenia with serious sepsis to give rise lo neumopaty; this patient broke off the treatment. One presented Zoster Herpes that was treated wlth ciclovir and temporary treatment break off. Conclusion MMF was effective to get remission in NL and maintain inactive LES, so it must to be considering as rescue therapy, or maintenance treatment after cyclosphosfarnide induction. In patients where fertility is important must be considering like eledive drug. Is necessary long time patients follow up to asses effectiveness in renal survival, like cyclophosfamide. La terapia a largo plazo con ciclofosfarnida combinada con esteroides mejora la sobrevida renal en pacientes con Nefritis Lúpica Proliferativa, pero con efectos tóxicos considerables. En años recientes, el Micofenolato Mofetil (MM?) un inmunosupresor usado en trasplante, parece ser efectivo en casos selectos de Nefritis Lúpica. Métodos Describiremos 6 pacientes con Nefritis Lúpica clase IV y y según OMS que por distintas razones debieron ser tratados con MM? como droga de rescate. El mismo estabilizó la función renal, controló la actividad del LES y permitió la disminución o suspensión del corticoide. Resultados En tres casos se logró remisión completa, dos presentaron remisión parcial y tuvimos un fracaso por plaquetopenia y leucopenia severa con sepsis grave a punto de partida de una neumopatía; en este paciente se suspendió el tratamiento. Uno de ellos presentó un herpes zóster que se trató con Aciclovir y la suspensión transitoria de MM?.. Conclusión EL MM? fue efectivo para conseguir remisiones en la NL y mantener inactivo el LES, por lo que se lo debiera considerar como terapia de rescate, o bien para tratamiento de mantenimiento luego de la inducción con ciclofosfamida, o directamente como terapia de inducción en aquellos pacientes donde la fertilidad es un factor importante. Seguimientos a largo plazo de las pacientes son necesarios para evaluar su efectividad en la sobreviva renal, como ya ha sido demostrado con la Ciclofosfamida. Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-11-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/26453 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 63 No. 3 (2006); 39 - 46 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 63 Núm. 3 (2006); 39 - 46 Revista da Faculdade de Ciências Médicas de Córdoba; v. 63 n. 3 (2006); 39 - 46 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/26453/28212 Derechos de autor 2019 Universidad Nacional de Córdoba |
| institution |
Universidad Nacional de Córdoba |
| institution_str |
I-10 |
| repository_str |
R-10 |
| container_title_str |
Revistas de la UNC |
| language |
Español |
| format |
Artículo revista |
| topic |
micofenolato mofetil lupus nephritis rescue treatment . |
| spellingShingle |
micofenolato mofetil lupus nephritis rescue treatment . Prettini, Viviana B Gastón F, Avila López Sesín, Ana M Dotto, Beatríz H Sanchez Freytes, Marcelo Sesín, Jorge Vergottini, Juan C Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| topic_facet |
micofenolato mofetil lupus nephritis rescue treatment . |
| author |
Prettini, Viviana B Gastón F, Avila López Sesín, Ana M Dotto, Beatríz H Sanchez Freytes, Marcelo Sesín, Jorge Vergottini, Juan C |
| author_facet |
Prettini, Viviana B Gastón F, Avila López Sesín, Ana M Dotto, Beatríz H Sanchez Freytes, Marcelo Sesín, Jorge Vergottini, Juan C |
| author_sort |
Prettini, Viviana B |
| title |
Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| title_short |
Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| title_full |
Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| title_fullStr |
Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| title_full_unstemmed |
Rescue therapy in lupus nephritis patients with micophenolato mofetil |
| title_sort |
rescue therapy in lupus nephritis patients with micophenolato mofetil |
| description |
Long term cyclophosfamide combinated steroids therapy improves renal survival in patients with Proliferate Lupus Nephritis, with considerable toxic effects. In lately years MM?, a irnmune suppressor used in transplant, seems lo be effective in selected cases of Lupus Nephritis.
Methods
We will describe six patients with Lupus Nephritis class IV and V (OMS Classification), that what different causes they must be treated with MM? like rescue drug. This stabilizes the renal funetion, controls LES activity and allows reductions or end of corticoids.
Results
In tree cases we achievement total remission, two show partial remission and we had a fail because plaquetopenia and severe leucopenia with serious sepsis to give rise lo neumopaty; this patient broke off the treatment. One presented Zoster Herpes that was treated wlth ciclovir and temporary treatment break off.
Conclusion
MMF was effective to get remission in NL and maintain inactive LES, so it must to be considering as rescue therapy, or maintenance treatment after cyclosphosfarnide induction. In patients where fertility is important must be considering like eledive drug. Is necessary long time patients follow up to asses effectiveness in renal survival, like cyclophosfamide. |
| publisher |
Universidad Nacional Cba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2019 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/26453 |
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