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Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
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Development and validation of a lectin-based assay for detection of IgG Fc glycosylation as a biomarker in lupus nephritis.

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Cognitive Screening and Neuropsychological Evaluation in Children and Young Adults With Childhood-Onset Systemic Lupus Erythematosus: A Survey of Rheumatologists.

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Key considerations for advancing chimeric antigen receptor (CAR) T-cell therapy for systemic lupus erythematosus (SLE): a multi-partner/disciplinary working group perspective.

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Do we really need cyclophosphamide for lupus nephritis?

Scott E Wenderfer1,2, Jennifer C Cooper3,4

  • 1Department of Pediatrics, The University of British Columbia, Vancouver, BC, Canada. scott.wenderfer@cw.bc.ca.

Pediatric Nephrology (Berlin, Germany)
|April 12, 2024
PubMed
Summary

This review examines initial treatment options for lupus nephritis, considering complex cases and resource limitations, to improve patient outcomes.

Keywords:
BelimumabChildhood-onset systemic lupus erythematosusCyclophosphamideImmunosuppressionLupus nephritisMycophenolate mofetil

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Area of Science:

  • Nephrology
  • Rheumatology
  • Immunology

Background:

  • Systemic lupus erythematosus (SLE) diagnosis in a 14-year-old confirmed by EULAR/ACR criteria.
  • Immune complex glomerulonephritis, ISN-RPS class IV, identified via kidney biopsy.
  • Current guidelines offer SLE nephritis treatment alternatives to cyclophosphamide.

Observation:

  • Clinical practice guidelines inadequately address severe SLE presentations like organ failure or neuropsychiatric involvement.
  • Access to advanced treatments like biologics is limited in many global regions.
  • The review focuses on initial treatment strategies for lupus nephritis.

Findings:

  • Cyclophosphamide is not the only option for SLE nephritis.
  • Severe SLE manifestations require tailored treatment approaches.
  • Resource availability impacts treatment choices for lupus nephritis.

Implications:

  • This review provides a framework for managing complex lupus nephritis cases.
  • It highlights the need for accessible and adaptable treatment protocols.
  • Optimizing initial therapy is crucial for long-term SLE patient prognosis.