Treatment of class II lupus nephritis with combination therapy of mycophenolic acid and corticosteroid; a case report

Faizal Armando Nugroho; Bayu Dharma Shanti; Widodo Widodo

doi:10.34172/jnp.2022.17267

doi: 10.34172/jnp.2022.17267

Abstract View: 1016

Case Report

Treatment of class II lupus nephritis with combination therapy of mycophenolic acid and corticosteroid; a case report

Faizal Armando Nugroho ¹^* , Bayu Dharma Shanti ¹ , Widodo Widodo ²

¹ Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo Hospital, Surabaya, Indonesia
² Lecturer and Consultant, Division of Kidney and Hypertension, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga - Dr Soetomo Hospital, Surabaya, Indonesia

*Corresponding author: Faizal Armando Nugroho, Email: dokterarmando@gmail.com; faizal.armando.nugroho-2016@fk.unair.ac.id

Abstract

Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE). Despite available guidelines recommendations on appropriate therapeutic agents, up to one-third of LN patients still do not meet expected response to initial corticosteroid or immunosuppressive treatment. We report a 17-year-old Indonesian female who was diagnosed LN with persistent proteinuria manifestations. Renal biopsy was suggestive of class II LN. Corticosteroid was given for a month without therapeutic response, and the patient was given combination of moderate dose methylprednisolone and mycophenolic acid resulted in complete remission after nine months therapy. Despite the existing guidelines, choices of LN treatment might be individual depends on disease severity (clinical, laboratory and histopathological findings) and demographic factors. The combination of mycophenolic acid and corticosteroid might be better option than high dose corticosteroid to treat class II LN for minimizing the adverse event of corticosteroid.

Keywords: Corticosteroids, Lupus nephritis, Mycophenolic acid, Systemic lupus erythematosus, Proteinuria, Glomerulonephritis

Implication for health policy/practice/research/medical education:

Despite the existing guidelines, choices of LN treatment might be individual depends on disease severity and demographic factors. The combination of mycophenolic acid and corticosteroid might be better option than increasing the dose of corticosteroid to treat class II LN unresponsive to corticosteroid therapy alone to minimize the adverse event of corticosteroid.

Please cite this paper as: Nugroho FA, Dharma Shanti B, Widodo W. Treatment of class II lupus nephritis with combination therapy of mycophenolic acid and corticosteroid; a case report. J Nephropathol. 2022;11(x):exx. DOI: 10.34172/jnp.2022.xx.

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