title: Successful pregnancy after cyclophosphamide therapy for lupus nephritis.
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) often requires administration of cyclophosphamide (CYC), especially for severe glomerulonephritis. As this disease usually affects young women in reproductive age, pregnancy, though not recommended may occur. The teratogenic effects of this drug make pregnancy prognosis and fetal survival indeterminate.
  
  
  METHODS
  We reviewed retrospectively the medical records of five patients with SLE who received inadvertently CYC during pregnancy and analyzed fetal outcome.
  
  
  RESULTS
  All patients were exposed at the first trimester. Two patients suffered miscarriages, two went to full term and one presented premature labor.
  
  
  CONCLUSIONS
  In spite of potential successful pregnancies after CYC exposure, this drug has teratogenic effects and prescription must be avoided during the pregnancy period. At the same time, the occurrence of these reported unplanned pregnancies strengthen the need of improving patients' education on pregnancy risks during immunosuppressive treatment.
authors.affiliation: Division of Rheumatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rua Dois de Dezembro, 131/702 Flamengo, Rio de Janeiro, RJ, 22220-040, Brazil.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Lannes
authors.forename: Fernanda R
authors.initials: FR
authors.lastname: Elias
authors.forename: Bernardo
authors.initials: B
authors.lastname: Cunha
authors.forename: Nilson
authors.initials: N
authors.lastname: Jesus
authors.forename: Evandro M
authors.initials: EM
authors.lastname: Klumb
authors.forename: Elisa M N
authors.initials: EM
authors.lastname: Albuquerque
authors.forename: Francinne M
authors.initials: FM
authors.lastname: Ribeiro
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D007231:Infant, Newborn; D008181:Lupus Nephritis / Q000188:drug therapy*; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide