title: [A patient with systemic lupus erythematosus and lupus nephritis: a 12-year follow-up].
abstract: BACKGROUND
  Systemic lupus erythematosus (SLE) is a chronic immunological disease causing a significant morbidity and mortality in younger women and involving several organs and systems, most often the kidneys, being consequently the incidence of lupus nephritis (LN) about 60%.
  
  
  METHODS
  We reported a 57 year-old patient with the diagnosed SLE in 1995. Pathohistological analysis of kidney biopsy revealed LN type V. The patient was treated with corticosteroid pulses and azathioprine during one year. A remission was achieved and maintained with prednisone, 15 mg daily. Nephrotic relapse was diagnosed in 2006 and the second kidney biopsy revealed recent kidney infarction due to extensive vasculitis. Soon, a cerebrovascul insult developed and CT-scan revealed endocranial infarctus. The patient was treated with corticosteroids and cyclophosphamide pulses (totally VI monthly pulses), and also with low-molecular heparine, anticoagulants and salicylates because of the right leg phlebothrombosis. After the pulses, the patient was adviced to take prednisone 20 mg daily and azothioprine 100 mg daily, and 6 months later mycophenolate mofetil because of persistent active serological immunological findings (ANA 1:320) and nephrotic syndrome. Mycophenolate mofetil was efficient in inducing and maintaining remission of nephrotic syndrome.
  
  
  CONCLUSIONS
  The aim of LN treatment is to achieve and maintain remission, improve patients' outcome, reduce the toxicity of immunosuppressive drugs and the incidence of relapses.Mycophenolate mofetil was shown to be efficient in inducing and maintaining remission of nephrotic syndrome in the frame of LN.
authors: Klinicki centar Srbije, Institut za urologiju i nefrologiju, Klinika za nefrologiju, Beograd, Srbija. naca@absolutok.net
authors: Natasa
authors: N
authors: Jovanović
authors: Jasmina
authors: J
authors: Marković-Lipkovski
authors: Stevan
authors: S
authors: Pavlović
authors: Biljana
authors: B
authors: Stojimirović
mesh_terms: D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008181:Lupus Nephritis / Q000150:complications* / Q000473:pathology; D008875:Middle Aged