Successful management of systemic lupus erythematosus nephritis flare-up during pregnancy with tacrolimus.
Systemic lupus erythematosus (SLE) is one of the common autoimmune disorders that affect women during their childbearing years. Disease activity frequently increases during pregnancy and the postpartum period, representing a challenge for both the patient and the treating physician(s). We report a case of successful management of lupus nephritis flare in the first trimester. The patient developed bilateral leg edema and nephrotic-range proteinuria of 5 g/day. She was treated with steroids and tacrolimus, which resulted in the induction of remission during pregnancy. The patient reached full-term with no maternal or fetal complications. This case indicates that tacrolimus, which is convenient to use and has limited adverse effects, may represent a potential safe and effective treatment option for SLE nephritis during pregnancy.
Alsuwaida
Abdulkareem
A
Department of Medicine, King Saud University, P.O. Box 2925, Riyadh, 11321, Saudi Arabia. alsuwaida@hotmail.com
D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D050498:Live Birth; D008181:Lupus Nephritis / Q000188:drug therapy*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011261:Pregnancy Trimester, First; D016559:Tacrolimus / Q000627:therapeutic use*; D047929:Term Birth
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016559:Tacrolimus