Efficacy and safety of Etanercept, high-dose intravenous gammaglobulin and plasmapheresis combined therapy for lupus diffuse proliferative nephritis complicating pregnancy.
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.
Micheloud
D
D
Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain.
Nuño
L
L
Rodríguez-Mahou
M
M
Sánchez-Ramón
S
S
Ortega
M C
MC
Aguarón
A
A
Junco
E
E
Carbone
J
J
Fernández-Cruzl
E
E
Carreño
L
L
López-Longo
F J
FJ
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*
D007074:Immunoglobulin G; D016756:Immunoglobulins, Intravenous; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept