[Eculizumab as rescue therapy for lupus nephritis-related thrombotic microangiopathy].
G Ital Nefrol
; 37(3)2020 Jun 10.
Article
in It
| MEDLINE
| ID: mdl-32530153
ABSTRACT
Thrombotic microangiopathy (TMA) is a frequent and severe complication in systemic lupus erythematosus (SLE). It is reported in almost 20-25% of renal biopsies of patients with lupus nephritis (LN) and is associated with a poor renal prognosis. We report the case of a patient suffering from an aggressive form of proliferative LN in association with thrombotic microangiopathy (TMA-LN), who was resistant to standard combined immunosuppressive treatment with corticosteroids and cyclophosphamide, as well as to plasma exchange (PEX). Eculizumab was given as a rescue therapy with an optimal clinical response. We performed a systematic review of the literature and identified 11 papers, published between 2011 and 2018, with a total of 20 patients, in which eculizumab was used, always as rescue therapy, to treat TMA-LN. All reported cases showed a positive clinical response to eculizumab with a high rate of remission. Even if sparse, available clinical cases and case series support the use of eculizumab in highly selected cases as rescue treatment for LN-TMA resistant to conventional combined immunosuppressive treatment.
Key words
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Database:
MEDLINE
Main subject:
Lupus Nephritis
/
Salvage Therapy
/
Complement Inactivating Agents
/
Thrombotic Microangiopathies
/
Antibodies, Monoclonal, Humanized
Type of study:
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Limits:
Female
/
Humans
/
Middle aged
Language:
It
Year:
2020
Type:
Article