Document Detail


Adjunctive plasma exchanges to treat neuropsychiatric lupus: a retrospective study on 10 patients.
MedLine Citation:
PMID:  17895305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neuropsychiatric manifestations of systemic lupus erythematosus (NPSLE) are among the main causes of morbidity and mortality attributed to lupus activity. Conventional NPSLE treatment combines CS and immunosuppressants, but some symptoms do not respond. We retrospectively evaluated the adjunction of plasma exchanges (PE) to treat 13 NPSLE flares occurring in 10 patients (mean age, 30 years) between 1989 and 2002. NP manifestations were the first SLE symptoms for seven patients, with a mean of 3.2 NP manifestations/flare. All patients received CS and cyclophosphamide pulses. A mean of 15 PE/flare were performed. All patients improved within a mean of 3 (median: 2.5; range: 1.5-8) weeks thereafter. Complete remissions of 7/13 flares were obtained within a mean of 7 (median: 4; range: 2-22) weeks. Partial remissions were achieved for the remaining six flares, characterized by new NP manifestations during three and insufficient control of the others. Other SLE manifestations regressed for all patients with the mean European consensus lupus activity measurement score declining from pretreatment 6.9 to 1.2. A regimen combining CS, cyclophosphamide and PE is effective against severe NPSLE, with acceptable toxicity.
Authors:
P Bartolucci; S Bréchignac; P Cohen; V Le Guern; L Guillevin
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Lupus     Volume:  16     ISSN:  0961-2033     ISO Abbreviation:  Lupus     Publication Date:  2007  
Date Detail:
Created Date:  2007-09-26     Completed Date:  2008-02-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9204265     Medline TA:  Lupus     Country:  England    
Other Details:
Languages:  eng     Pagination:  817-22     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Université Descartes Paris 5, 27 rue du Faubourg Saint-Jacques, 75679 Paris Cedex 14, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Combined Modality Therapy
Cyclophosphamide / therapeutic use,  toxicity
Cyclosporine / therapeutic use,  toxicity
Drug Therapy, Combination
Female
Humans
Lupus Vasculitis, Central Nervous System / therapy*
Male
Middle Aged
Plasma Exchange*
Remission Induction
Retrospective Studies
Severity of Illness Index
Chemical
Reg. No./Substance:
50-18-0/Cyclophosphamide; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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