Successful treatment of severe crescentic lupus nephritis by multi-target therapy using tacrolimus and mycophenolate mofetil
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Treatment of severe lupus nephritis (LN) has been controversial, and according to recent guidelines and recommendations, cyclophosphamide still remains a first-line therapy. Herein, we present the case of a 37-year-old female patient who developed rapidly progressive glomerulonephritis, which was histologically diagnosed as class IV + V LN, with a large number of cellular to fibrocellular crescents (62 % of glomeruli). Although the patient was considered to have the most severe form of LN, complete remission was achieved within 6 months by multi-target therapy using tacrolimus and mycophenolate mofetil combined with methylprednisolone pulse therapy. Our experience suggests that multi-target therapy could be a potential treatment option for patients with severe crescentic LN.
KeywordsCrescentic lupus nephritis Multi-target therapy Mycophenolate mofetil Lupus nephritis Tacrolimus
Conflict of interest
K. Hiromura has received honoraria for lectures and research grants from Astellas Pharma Inc and honoraria for lectures from Chugai Pharmaceutical, Co., Ltd. H. Ikeuchi has received research grants from Chugai Pharmaceutical, Co., Ltd. A. Maeshima has received research grants from Astellas Pharma Inc. Y. Nojima has received honoraria for lectures and research grants from Astellas Pharma Inc and research grants from Chugai Pharmaceutical, Co., Ltd.
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