title: Total lymphoid irradiation in refractory systemic lupus erythematosus.
abstract: In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental.
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology / Q000532:radiotherapy*; D008213:Lymphocyte Activation / Q000528:radiation effects; D008221:Lymphoid Tissue / Q000528:radiation effects*; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D011832:Radiation Injuries; D011879:Radiotherapy Dosage
chemical_list: D001379:Azathioprine; D011241:Prednisone