title: Successful management of systemic lupus erythematosus nephritis flare-up during pregnancy with tacrolimus.
abstract: 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.
authors.affiliation: Department of Medicine, King Saud University, P.O. Box 2925, Riyadh, 11321, Saudi Arabia. alsuwaida@hotmail.com
authors.forename: Abdulkareem
authors.initials: A
authors.lastname: Alsuwaida
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016559:Tacrolimus