Effective treatment of a refractory case of systemic lupus erythematosus with low-dose tacrolimus

• OKI Eishin

  Department of Pediatrics, Hirosaki University School of Medicine

• TSUGAWA Koji

  Department of Pediatrics, Hirosaki University School of Medicine

• SUZUKI Koichi

  Department of Pediatrics, Hirosaki University School of Medicine

• TANAKA Hiroshi

  Department of Pediatrics, Hirosaki University School of Medicine

Bibliographic Information

Other Title

• 少量タクロリムス療法が有効であった再燃を繰り返す全身性エリテマトーデス症例
• ショウリョウ タクロリムス リョウホウ ガ ユウコウ デ アッタ サイネン オ クリカエス ゼンシンセイ エリテマトーデス ショウレイ

Abstract

It has been reported that aggressive immunosuppressive treatment is effective for controlling the disease activity of refractory systemic lupus erythematosus (SLE). However, little information on a regimen including tacrolimus (TL) for the treatment of refractory SLE has been available. We report a successful low dose TL treatment of a 25-year-old male patient with refractory SLE. He developed SLE with proliferative lupus nephritis (WHO class IVb) at the age of 11 years. During the past 4 years, despite aggressive immunosuppressive treatment consisting of methylprednisolone pulse therapy, mizoribine pulse therapy, cyclosporine A and intravenous cyclophosphamide pulse therapy, frequent flares associated with presumptive hypercytokinemia i.e., increased levels in the serum C-reactive protein, ferritin and soluble IL-2 receptor, occurred. Hence, administration of low-dose TL at 3mg per day, was initiated. The blood levels of TL at approximately 12 hours post-dosing were maintained at between 3 and 5ng/mL. Within 3 weeks following TL administration, the serum levels of C3, C4 and CH50 began to increase rapidly, and the prednisolone dose could be successfully tapered. No adverse effects of TL were observed.<br>We suggest that TL may be the treatment of choice for selected patients with refractory SLE.

Journal

• The Japanese Journal of Nephrology

  The Japanese Journal of Nephrology 49 (8), 1020-1024, 2007

  Japanese Society of Nephrology

Keywords

• systemic lupus erythematosus
• tacrolimus
• systemic lupus erythematosus disease activity index

Details

• CRID: 1390282679837673728
• NII Article ID: 130004170826
• NII Article ID: 10021273889
• NII Book ID: AN10131749
• DOI: 10.14842/jpnjnephrol1959.49.1020
• ISSN: 18840728
• ISSN: 03852385
• NDL BIB ID: 9308780
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I9308780
• Web Site: https://search.jamas.or.jp/link/ui/2008105282
• Text Lang: ja
• Data Source:
  • JaLC
  • NDL
  • CiNii Articles
• Abstract License Flag: Disallowed