Vnitr Lek 1989, 35(2):137-144

[Evaluation of long-term immunotherapy in patients with lupus nephritis].

D Zitnan, J Lukác, J Rovenský

In 177 patients with lupus nephritis in the course of three decades three methods of immunotherapy were used the effect of which was evaluated retrospectively. When the criterium of the survival period was used, it was revealed that from a group of 66 patients treated only with glucocorticoids (mainly prednisone by the oral route) less than 60% survived five years the onset of lupus nephritis, only 33% survived 10 years. From a group of 81 patients treated with glucocorticoids and cytostatics (mostly cyclophosphamide by the oral route) 80% survived five years and 50% ten years, while in a group of 30 patients treated with glucocorticoids, cyclophosphamide and levamisole 90% survive five years and as many as 70% ten years from the onset of lupus nephritis. From the onset of SLE however as many as 80% survived ten years in all three analyzed groups, which provides evidence that lupus nephritis accounts for the greatest mortality in patients with SLE, as renal failure was the cause of death in one third of the patients. As to complications, secondary infections were recorded in almost 30% of the patients, incl. 9% lethal ones, non-infections complications less than 5%. The authors discuss assumed mechanism of the action of combined immunotherapy, which holds a priority position, as compared with glucocorticoid monotherapy.