Abstract
Fifteen cases with severe systemic lupus erythematosus (SLE) were treated with bolus administration of methylprednisolone and 10 of them had marked improvement of subjective symptoms.
They were grouped into central nerveous system involvement (CNS-lupus) group with neurologic signs, CNS-lupus group with psychiatric illness, a group with lupus nephritis, a patient with vasculitis and the others. 6 cases of the 9 CNS-lupus patients with neurologic signs, 2 cases of the 3 lupus nephritis patients, a patient with vasculitis were involved in “good response group”: Psychiatric illness of 3 CNS-lupus cases on the other hand, did not show any clinical improvement.
The mean pheripheral white blood cell (WBC) count rose from 4, 200/mm3 at the start of therapy to 7, 050/mm3 within 4 weeks after pulse therapy (p<0.005) and WBC count of all cases recovered to normal range. Antinuclear antibody (ANA) titer decreased in only 2 (15.4%) of the 13 ANA positive cases. Low serum complement activity (CH50) became normal range after treatment only in 15.4% of the cases. The improvement of the ANA titer and the value of CH50 did not correlate with that of clinical symptoms in each case. In many cases, the improvement of ANA titer and the value of CH50 appeared within 16 weeks after pulse therapy.
Three of 15 cases complicated severe infection as adverse effects of methylprednisolone, and one of them had diabetes mellitus and hypertension.
