CYCLOPHOSPHAMIDE AS A REMISSION-INDUCING DRUG IN A PATIENT WITH LUPUS: CASE REPORT

Abstract

Systemic Lupus Erythematosus is defined as an autoimmune disease, of chronic inflammatory character, more frequent in women of childbearing age and that typically presents multisystemic involvement, manifesting itself through periods of activity and remission, with great phenotypic variability1.  Among the various possibilities of renal involvement in SLE, Lupus Nephritis (NL) is the most common form of renal injury, affecting approximately 50% of patients1. This manifestation gains even importance because it is the main indication for the use of high doses of corticosteroids and immunosuppressants, as well as the main factor related to mortality1. The treatment of PATIENTS WITH NL aims to achieve the complete clinical response to immunosuppressive therapy, since it is directly proportional to long-term renal survival. Currently, there are guidelines such as that of the Brazilian Society of Rheumatology and the International Society of Nephrology that guide medical practice, regarding the diagnosis and treatment of NL. However, it is evident that the emergence of new medications and new therapeutic protocols make room for discussions and studies on the management of these patients. The present study aims, therefore, to discuss the remission-inducing therapy with the use of cyclophosphamide in a 35-year-old female patient with severe SLE, associated with NL and cutaneous, serous, hematological and overlap with Antiphospholipid Antibody Syndrome (SAAF).