title: [Successful treatment of early intervention with tacrolimus for a patient with lupus nephritis III+V].
abstract: A 55-year-old woman developed bilateral leg edema in June 2006. Since the edema tended to worsen, she visited our hospital on November 11. Laboratory tests showed a serum albumin level of 2.5 g/dl with 3+ proteinuria, and suggested nephrotic syndrome, which led to her hospitalization on November 14. The findings of discoid erythema, an antinuclear antibody titer of 1: 640, anti-ds DNA antibody titer of 16.8 IU/ml, and ISN/RPS class III (A/C)+V lupus nephritis on kidney biopsy led to the diagnosis of systemic lupus erythematosus. Treatment with prednisolone at 1 mg/kg/day was initiated. Despite an increase in complement levels and decreases in anti-ds DNA antibody titers and immune complexes, proteinuria persisted; therefore, the patient was concomitantly given 125 mg/day of azathioprine, which was discontinued because of the poor improvement of proteinuria and development of myelosuppression, and replaced by 3 mg/day of tacrolimus (Tac), with a consequent marked improvement in proteinuria. We report a patient with refractory proteinuria due to class III/V lupus nephritis who achieved a Tac-induced complete remission.
authors.affiliation: First Department of Internal Medicine, Osaka Medical College. Takatsuki, Osaka.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Takuya
authors.initials: T
authors.lastname: Kotani
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Isoda
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hata
authors.forename: Koko
authors.initials: K
authors.lastname: Watanabe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shoda
authors.forename: Toru
authors.initials: T
authors.lastname: Inoue
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
mesh_terms: D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008181:Lupus Nephritis / Q000188:drug therapy*; D008875:Middle Aged; D016559:Tacrolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus