title: Methotrexate for steroid-resistant systemic lupus erythematosus.
abstract: 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.
authors.affiliation: Department of Clinical Immunology, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hashimoto
authors.forename: S
authors.initials: S
authors.lastname: Nonaka
authors.forename: E
authors.initials: E
authors.lastname: Furuta
authors.forename: T
authors.initials: T
authors.lastname: Wada
authors.forename: Y
authors.initials: Y
authors.lastname: Suenaga
authors.forename: M
authors.initials: M
authors.lastname: Yasuda
authors.forename: M
authors.initials: M
authors.lastname: Shingu
authors.forename: M
authors.initials: M
authors.lastname: Nobunaga
mesh_terms: 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*
chemical_list: D011239:Prednisolone; D008775:Methylprednisolone; D008727:Methotrexate