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ORIGINAL ARTICLE
Year : 2022  |  Volume : 7  |  Issue : 2  |  Page : 53-57

Efficacy and short term outcome of intravenous cyclophosphamide therapy in children with lupus nephritis: A tertiary hospital study of Bangladesh


Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Correspondence Address:
Dr. Mohammad Imnul Islam
Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/pnjb.pnjb_18_22

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Background: Renal involvement is one of the most common and severe manifestations of paediatric systemic lupus erythematosus patients. Intravenous pulse cyclophosphamide (CYC) therapy is effective for lupus nephritis patients observed in different studies. Objective: To evaluate the efficacy and short term outcome of intravenous CYC therapy in renal involvement among paediatric SLE cases. Materials and Methods: This retrospective study was conducted at the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University from January 2018 to December 2021. Sixty-two pSLE patients with renal involvement who met ACR revised classification criteria and completed their follow-up were enrolled in the study. All patients received intravenous CYC monthly for six months along with initially intravenous pulse methylprednisolone followed by oral prednisolone. During the study period, patients were monitored clinically and laboratory evaluations were done at baseline, 3rd and after 6th months of follow-up. Results: Among the cases, the female:male ratio was 5.9:1 and mean age was found 12.42 ± 2.13 years. After 3 months of CYC therapy, most patients were clinically improved in haematuria, hypertension, oedema, SLEDAI score and biochemically by ESR, C3, C4, S, Creatinine, Anti-ds-DNA titers, 24-hour urine protein. These initial improvements were further enhanced after 6 months of therapy. Short term outcomes demonstrated that 50%, 38.7% and 11.3% of patients had complete, partial and no responses respectively at the last follow-up. Conclusion: Intravenous CYC therapy effectively treated lupus nephritis patients observed in this study. Around 88% of pSLE patients had complete and partial responses according to EULAR criteria. Hypertension, ant-ds-DNA titers, proteinuria and serum complements were identified as a predictor of remission.


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