ĐÁNH GIÁ KẾT QUẢ NGẮN HẠN ĐIỀU TRỊ VIÊM THẬN LUPUS NẶNG TẠI BỆNH VIỆN THỐNG NHẤT

Abstract

Object: To evaluate the outcome of severe lupus nephritis (LN) treatment with the pulse corticosteroids therapy combined with mycophenolate mofetil (MMF) and plasma exchange at the Department of Nephrology - Dialysis, Thong Nhat Hospital. Materials and method: A retrospective, case series study was conductes in 15 severe Lupus nephritis patients from May 2020 to July 2022. Inclusion criteria were (1) Patienst 15 years or older, (2). Diagnosis of systemic lupus erythematosus (SLE) by EULAR-ACR 2019 criteria, (3). Renal disorder with proteinuria > 0.5g/24h, (4). Severe clinical manifestation including renal flare and/or lupus flare. Results: The mean age (SD) was 31.73 ± 11.5 years. Female patients were 13/15 (86.70%). The percentage of patients diagnosed with SLE for the first time was 8/15 (53.30%). There were 7 patients performed kidney biopsy and 5 of them had the presence of crescents which is classified as class IV (ISN/RPS 2018). There were 12/15 patients responded with complete remission (80%). Death occurred in 3 patients, of which 2 patients had severe infection rafter steroid pulse therapy. Conclusion: Treatment of severe LN with pulse corticosteroid therapy combined with MMF and plasma exchange for some selected cases gives good results. Mortality occurred in LN patients with complications of multi - organs and infection after pulse steroid.