Methotrexate for steroid-resistant systemic lupus erythematosus.
We here report two patients with steroid-resistant systemic lupus erythematosus (SLE) who were successfully treated with methotrexate (MTX). In both cases, a steroid resistant high fever, associated with mild myositis and pancytopenia were the main common findings, and all these symptoms were alleviated within a few days either by 7.5 mg or 5 mg MTX per week. The number of CD4+ cells increased along with the clinical improvement, whereas the number of CD20+ cells and HLA-DR expressing cells also decreased. Taking into account the side effects of high dose corticosteroids and cyclophosphamides, treatment with a weekly low dose of MTX is known to contribute to an improvement in the long-term prognosis for patients with refractory SLE.
Hashimoto
M
M
Department of Clinical Immunology, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan.
Nonaka
S
S
Furuta
E
E
Wada
T
T
Suenaga
Y
Y
Yasuda
M
M
Shingu
M
M
Nobunaga
M
M
D000328:Adult; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000503:physiopathology*; D008727:Methotrexate / Q000627:therapeutic use*; D008775:Methylprednisolone / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use*
D011239:Prednisolone; D008775:Methylprednisolone; D008727:Methotrexate