title: [Treatment of diffuse glomerulonephritis in systemic lupus erythematosus with a combination of anticoagulants, corticosteroids and immunosuppressors].
abstract: 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.
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D005260:Female; D005921:Glomerulonephritis / Q000188:drug therapy*; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009402:Nephrosis, Lipoid / Q000188:drug therapy; D013997:Time Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000925:Anticoagulants; D007166:Immunosuppressive Agents
vernacular_title: Lechenie na difuznite glomerulonefrite pri sistemniia lupus erythematodes sŭs sŭchetanie ot antikoagulanti, kortikosteroidi i imunosupresori.