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Efficacy and safety of Etanercept, high-dose intravenous gammaglobulin and plasmapheresis combined therapy for lupus diffuse proliferative nephritis complicating pregnancy

Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain

L Nuño

Rheumatology Department, University General Hospital Gregorio Marañón, Madrid, Spain

M Rodríguez-Mahou

Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain

S Sánchez-Ramón

Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain

M C Ortega

Rheumatology Department, University General Hospital Gregorio Marañón, Madrid, Spain

A Aguarón

Obstretics and Gynecology Department, University General Hospital Gregorio Marañón, Madrid, Spain

E Junco

Nephrology Department, University General Hospital Gregorio Marañón, Madrid, Spain

J Carbone

Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain

E Fernández-Cruz

Immunology Department, University General Hospital Gregorio Marañón, Madrid, Spain

L Carreño

Rheumatology Department, University General Hospital Gregorio Marañón, Madrid, Spain

F J López-Longo

Rheumatology Department, University General Hospital Gregorio Marañón, Madrid, Spain, fjlopezlongo{at}hotmail.com

We report one case of pregnancy-onset severe diffuse proliferative nephritis in a patient with systemic lupus erythematosus (SLE), who was successfully treated with a combination of anti-tumour necrosis factor (TNF)-alpha, plasmapheresis and high-dose intravenous gammaglobulin. No flares were observed either in clinical symptoms or in laboratory examinations during pregnancy or after delivery. Her autoantibodies except fluorescent anti-nuclear antibodies were negative. We suggest that a combination of anti-TNF-alpha, plasmapheresis and high-dose intravenous gammaglobulin may be a safe and effective therapy for pregnant patients suffering severe lupus nephritis.

Key Words: systemic lupus erytematosus • pregnancy • etanercept • intravenous gammaglobulin and plasmapheresis.

Lupus, Vol. 15, No. 12, 881-885 (2006)
DOI: 10.1177/0961203306070970


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