title: Efficacy and safety of Etanercept, high-dose intravenous gammaglobulin and plasmapheresis combined therapy for lupus diffuse proliferative nephritis complicating pregnancy.
abstract: We report one case of pregnancy-onset severe diffuse proliferative nephritis in a patient with systemic lupus erythematosus (SLE), who was successfully treated with a combination of anti-tumour necrosis factor (TNF)-alpha, plasmapheresis and high-dose intravenous gammaglobulin. No flares were observed either in clinical symptoms or in laboratory examinations during pregnancy or after delivery. Her autoantibodies except fluorescent anti-nuclear antibodies were negative. We suggest that a combination of anti-TNF-alpha, plasmapheresis and high-dose intravenous gammaglobulin may be a safe and effective therapy for pregnant patients suffering severe lupus nephritis.
authors.affiliation: Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Micheloud
authors.forename: L
authors.initials: L
authors.lastname: Nuño
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Mahou
authors.forename: S
authors.initials: S
authors.lastname: Sánchez-Ramón
authors.forename: M C
authors.initials: MC
authors.lastname: Ortega
authors.forename: A
authors.initials: A
authors.lastname: Aguarón
authors.forename: E
authors.initials: E
authors.lastname: Junco
authors.forename: J
authors.initials: J
authors.lastname: Carbone
authors.forename: E
authors.initials: E
authors.lastname: Fernández-Cruzl
authors.forename: L
authors.initials: L
authors.lastname: Carreño
authors.forename: F J
authors.initials: FJ
authors.lastname: López-Longo
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage* / Q000009:adverse effects; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D007231:Infant, Newborn; D008181:Lupus Nephritis / Q000188:drug therapy*; D008297:Male; D010956:Plasmapheresis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011256:Pregnancy Outcome; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*
chemical_list: D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept