title: [Treatment of severe systemic lupus erythematosus. Long-term results in 55 patients (author's transl)].
abstract: Out of 55 patients with severe systemic lupus erythematosus (SLE) retrospectively studied from 1962 to 1979, 32 had diffuse proliderative glomerulonephritis and 23 had one or several extrarenal and/or haematological manifestations of the disease. All received corticosteroids in high dosage (0,8 to 1,5 up period was 48 months from the beginning of treatment. The actuarial survival rates for the whole groupe after 1,5 and 10 years were 92,4%, 83,4% and 77,2% respectively. Eight patients died: 5 of SLE and 3 of iatrogenic complications. Four are kept alive by maintenance haemodialysis. At the end of the study period, SLE was quiescent in 37 patients, including 14 who had discontinued corticosteroids for 5 to 72 months. The five-year survival rates were very similar in patients with renal and extrarenal involvement (86,4% and 81,6% respectively). In the latter group myocardial insufficiency, thrombopenia and thromboembolic complications were the main factors of morbidity and mortality. Corticosteroids were administered alone to 25 patients and in combination with cyclophosphamide to the remaining 30. Cyclophosphamide was given initially in 13 cases or subsequently on account of intolerance (7 cases) or resistance (10 cases) to steroids. Similar results were obtained with these two therapeutic regimens, but it must be noted that cyclophosphamide was mainly used in the more severe forms of SLE.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D001927:Brain Diseases / Q000209:etiology; D003520:Cyclophosphamide / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D008297:Male; D013921:Thrombocytopenia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D003520:Cyclophosphamide
vernacular_title: Traitement des formes sévères du lupus érythémateux disséminé. Résultats à long terme chez 55 malades.