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Medical Journal of Islamic Republic of Iran، جلد ۱۹، شماره ۲، صفحات ۱۰۹-۱۱۷
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عنوان انگلیسی COMBINATION THERAPY WITH PULSE CYCLOPHOSPHAMIDE PLUS CORTICOSTEROIDS IMPROVES RENAL OUTCOME IN PATIENTS WITH LUPUS NEPHRITIS
چکیده انگلیسی مقاله  ABSTRACT Background: The prognosis of SLE is int1uenced by the onset of glomerulonephtitis. Clinical ttials in lupus nephritis have demonstrated that cyclophosphamide therapy is the superior regimen in the management oflupus nephritis for preserving renal function. Objective: The purpose of this study is to define the outcome of renal function with bolus pu lses of cyclophosphamide and steroid according to our protocol and also to determine an appropriate pattern of treatment of lupus nephritis. Methods: In this open-label clinical triaL to evaluate the results, the short-term prognosis and the rate of complications of an immunosuppressive regimen with corticosteroids and cyclophosphamide, twenty-five patients with biopsy-proven lupus nephritis were studied. Treatment was structured in 4 phases: I) Induction with bolus methylprednisolone and cyclophosphamide. 2) Maintenance with oral prednisolone for 4 weeks and monthly cyclophosphamide pulses for 6 months. 3) Tapeting with reduction of prednisolone by 10% each month and continuing cyclophosphamide every other month till one year and for the second year every 3 months. 4) Discontinuation with oral prednisolone slowly tapered to the least effective daily dose and cyclophosphamide discontinued after 2 yr of therapy. We defined primary outcome measures according to these criteria: renal function return to normal limits or become stable, regression of systemic and local inflammatory symptoms. urine protein excretion h1lling below 0.3 gr/ elL or by at least SOo/c. RBC cast disappearance, C3, C4, Hb, and ESR return to notmallimits. Result: Twenty-three patients wi th lupus nephritis completed our therapeutic protocol. Renal biopsy was perfonned in 22 cases and indicated type IV in 20 patients (95.2%), and type V in 2 patients. After an average of 4+ 1.95 months 22 patients achieved remission (95.65%) and only one case remained non-responsive. She became pregnant in her fourth month of therapy. Significant statistical differences were achieved between creatinine, proteinuria, hematuria, leukocyturia, urinary cast, C3, C4, ESR, and Hb before and after therapy (p< 0.05). Plasma creatinine fell from 1 .44+0.95 mg/dL to 0.97+0. 78 (p< 0.004). Proteinuria fell from 1879.78+ 1854.46 to 408.34+572.92 mg/24h (p
کلیدواژه‌های انگلیسی مقاله Lupus nephriti s-Cyc lophosphamide- Glomerulonephritis.
نویسندگان مقاله z رضایی یزدی | z rezaie yazdi
c;hac·m hospital. mashhadl apos;ni1 ersit1· o apos; medical science. mashhad. iran.


j فرقانی زاده | j. forghanizadeh
iran university of medical sciences,tehran. iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

j رضایی | j. rezaie
azad university of medical sciences. mashhad. iran.


p صالحیان | p. salehian
iran university of medical sciences,tehran. iran.

سازمان اصلی تایید شده: دانشگاه علوم پزشکی ایران (Iran university of medical sciences)

h منصوری طرقبه | h mansouri torghabeh
l apos;arhiat apos;vi amp;lt;hlarres medica l uninversity, tehran. iran.
نشانی اینترنتی http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-273&slc_lang=en&sid=en
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