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Pentoxifylline in the Treatment of Refractory Nephrotic Syndrome Secondary to Lupus Nephritis
GRISELDA GALINDO-RODRÍGUEZ, REYNA BUSTAMANTE, GERARDO ESQUIVEL-NAVA, DANIEL SALAZAR-EXAIRE, JORGE VELA-OJEDA, MANUEL VADILLO-BUENFIL, and J. ANTONIO AVIÑA-ZUBIETA
ABSTRACT.
Methods. We studied 11 patients who met the following inclusion criteria: (1) systemic lupus erythematosus (SLE) according to the American College of Rheumatology criteria; (2) lupus nephritis class III, IV, or V according to the World Health Organization; (3) proteinuria in the nephrotic range (³ 3 g/24 h) for at least 6 months despite treatment. All patients received pentoxifylline 800–1600 mg/day. Clinical and laboratory data, including creatinine, urine test, creatinine clearance, and 24-h urinary protein, were collected monthly for 6 months. No changes in treatment were allowed, except for alterations in the dose of prednisone. Results. All patients had received corticosteroids and immunosuppressants for at least 6 months. All patients showed a decrease in proteinuria concentrations after use of pentoxifylline from a median of 5.5 to 2.0 (p = 0.003). No patient discontinued the drug due to side effects. One patient had nausea and one had anxiety that disappeared after decreasing the dosage. Conclusion. Pentoxifylline seems to be effective in the treatment of refractory nephrotic syndrome secondary to lupus nephritis. (J Rheumatol 2003;30:2382–4) Key Indexing Terms:
LUPUS
From the Rheumatic Disease Unit and the Clinical Epidemiology Research Unit, Hospital de Especialidades Centro Médico Nacional "La Raza," Instituto Mexicano del Seguro Social, Mexico City, Mexico. G. Galindo-Rodríguez, MD; R. Bustamante, MD, Rheumatic Disease Unit; G. Esquivel-Nava, MD; D. Salazar-Exaire, MD, PhD; J. Vela-Ojeda, MD; M. Vadillo-Buenfil, MD, Clinical Epidemiology Research Unit; J.A. Aviña-Zubieta, MD, MSc, Rheumatic Disease Unit and Clinical Epidemiology Research Unit. Address reprint requests to Dr. J.A. Aviña-Zubieta, Unidad de Investigación en Epidemiología Clínica, Piso 10, Hospital de Especialidades CMN La Raza-IMSS, Seris y Zaachila SN, Col. La Raza, México, D.F. México 02990. E-mail: aavina100@hotmail.com Submitted December 9, 2002; revision accepted April 15, 2003. |