Case | Age (years) | Renal pathology | Dose of PSL (or equivalent) mg/kg bw/day | *Intensive immunosuppressive therapies | SLEDAI | Treatment response | ||||
Glomerular lesion (International Society of Nephrology/Renal Pathology Society 2003) | Interstitial lesion | Before | After (observation period, weeks) | |||||||
Lymphocyte infiltration | Tubular atrophy | Vasculopathy | ||||||||
1 | 50 | III(A) | + | + | − | 1 | b-IVCY (2) | 26 | 2 (4) | I |
2 | 16 | IV-G(A/C) | + | + | + | 0.8 | IVCY (1)+pulse mPSL (3)+IA (1) | 25 | 20 (4) | SF |
3 | 44 | IV-G(A/C) | + | + | − | 1 | b-IVCY (2) | 19 | 14 (4) | SF |
4 | 41 | IV | ? | ? | ? | 0.8 | IVCY (1)+pulse mPSL (3)+IA (1)+PE (1) | 36 | 29 (4) | SF |
5 | 44 | IV-G(A/C) | + | + | − | 0.8 | IVCY (1)+MTX | 14 | 10 (4) | I |
6 | 34 | III(A) | + | + | − | 1 | CsA | 12 | 6 (2) | I |
7 | 41 | IV | ? | ? | ? | 0.8 | RTX | 30 | 38 (4) | SF |
8 | 42 | IV-S(A) | + | + | + | 1 | IVCY (1) | 12 | 12 (4) | SF |
9 | 16 | IV-G(A/C) | + | + | + | 0.8 | b-IVCY (2)+IA (1) | 20 | 10 (3) | I |
10 | 42 | IV-S(A) | + | + | + | 0.8 | IVCY (1) | 12 | 8 (2) | I |
11 | 38 | IV-S(A) | + | − | − | 0.8 | IVCY (1)+IA (1) | 22 | 16 (4) | SF |
12 | 39 | IV-G(A/C) | ? | ? | ? | 1 | IVCY (1)+IA (1) | 28 | 20 (2) | SF |
↵*Numbers in parentheses represent the number of times of treatment in an observation period.
?, interstitial lesion could not be investigated in detail because renal biopsy was performed in other hospitals before transfer to our hospital; b-IVCY, biweekly IVCY; bw, body weight; CsA, ciclosporin; I, patient of the ‘improvement group’; IA, immunopheresis; IVCY, monthly intravenous cyclophosphamide pulse therapy; MTX, methotrexate; PE, plasma exchange; PSL, prednisolone (or equivalent); pulse mPSL, methyl-prednisolone pulse therapy; RTX, rituximab; SF, patient of the ‘severe flare group’; SLEDAI, Systemic Lupus Erythematosus Disease Activity Index.