Plasma exchange and immunosuppressive therapy in a paediatric patient with systemic lupus erythematosus.

Abstract

A case is reported of systemic lupus erythematosus (SLE) associated with steroid-resistant nephrotic syndrome. Serial plasma exchanges (PE) combined with prednisolone treatment induced complete normalization of the immunological findings: the anti-DNA antibody, antinuclear antibody, LE cell phenomenon and circulatory immune complexes became negative. The prostacyclin (PGI2) production-supporting activity in the plasma increased to the control range; inhibitors of PGI2 production were eliminated. The creatinine clearance normalized, the urinary protein excretion decreased significantly, and the facial erythema disappeared. Continued treatment with chlorambucil + low-dose prednisolone led to a complete and stable remission of the nephrotic syndrome, and the C3 complement normalized. The low level of PGI2 production-supporting activity in the plasma may be explained by the inhibitor of PGI2 production. PE + immunosuppressive therapy might have beneficial effects on the immunological changes and PGI2 metabolism, and also on the remission of SLE-nephrotic syndrome.

• Authors: S Túri, I Haszon, T Bodrogi
• Journal: Acta paediatrica Hungarica (Acta Paediatr Hung) 1988-1989 Vol. 29 Issue 3-4 Pg. 293-8 ISSN: 0231-441X [Print] Hungary
• PMID: 3151982 (Publication Type: Case Reports, Journal Article)

Chemical References

• Autoantibodies
• Immunosuppressive Agents
• Chlorambucil
• Prednisolone
• Epoprostenol

Topics

• Autoantibodies (analysis)
• Child
• Chlorambucil (therapeutic use)
• Epoprostenol (biosynthesis)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lupus Erythematosus, Systemic (complications, drug therapy, therapy)
• Lupus Nephritis (complications)
• Male
• Nephrotic Syndrome (drug therapy, etiology, therapy)
• Plasma Exchange
• Prednisolone (therapeutic use)