Abstract
We treated a lupus nephritis patient refractory to conventional therapy with mycophenolate mofetile (MMF). She was diagnosed as systemic lupus erythematosus (SLE) at age 4 and soon involved nephritis. Renal histopathological diagnosis made two years later was WHO class IV. She received oral administration of prednisolone, cyclophosphamide, mizoribine, azathioprine, and cyclospoline as well as intravenous pulse therapy of methylprednisolone and cyclophosphamide. However, all failed to control her nephritis or disease activity of SLE. Before treatment with MMF, urinary protein excretion was 11.6 g/day, serum albumin 2.4 g/dl, C3c 37.4 mg/dl, and anti ds-DNA antibody 38 IU/ml. After initiation of MMF, proteinuria began to decrease within 3 weeks and has been below 1 g/day since 10 weeks. Serum activity indices of lupus; C3c and anti ds-DNA antibody, also improved to normal levels. We believe MMF should be used for refractory lupus nephritis with conventional therapy.
