Good response of membranous lupus nephritis to tacrolimus

M. Maruyama, Y. Yamasaki, Kenei Sada, A. Sarai, K. Ujike, Y. Maeshima, Y. Nakamura, Hitoshi Sugiyama, Hirofumi Makino

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

A 22-year-old woman hospitalized for polyarthralgia was diagnosed with systemic lupus erythematosus (SLE). She was treated with prednisolone, and her clinical manifestations improved. However, she was re-admitted for renal biopsy because of persistent hypocomplementemia and development of proteinuria. The biopsy revealed segmental spike formation of basement membrane and subepithelial immune complex deposition, and membranous lupus nephritis (class V) was diagnosed. When tacrolimus was added to prednisolone, the serum complement titer quickly improved and proteinuria disappeared after about 11 months. Nevertheless, when tacrolimus was replaced examination showed cyclosporine due to gastrointestinal symptoms, she complained about arthralgia. Examination showed drop in the serum complement titer and recurrence of proteinuria. Renal biopsy at the time of recurrence showed increased subepithelial immune complex deposition in the capillary loops as compared to the first biopsy, a high degree of thickening of the basement membrane, and segmental circumferential interposition in some of the glomeruli. Membranous lupus nephritis (classes V + III) was diagnosed. By changing to tacrolimus and higher doses of steroids, the serum complement titer improved and proteinuria disappeared. This case indicates that tacrolimus can be an effective therapeutic agent for membranous lupus nephritis.

Original languageEnglish
Pages (from-to)276-279
Number of pages4
JournalClinical Nephrology
Volume65
Issue number4
Publication statusPublished - Apr 2006

Fingerprint

Lupus Nephritis
Complement Hemolytic Activity Assay
Tacrolimus
Proteinuria
Biopsy
Arthralgia
Prednisolone
Antigen-Antibody Complex
Basement Membrane
Kidney
Recurrence
Systemic Lupus Erythematosus
Cyclosporine
Steroids
Therapeutics

Keywords

  • Cyclosporine
  • Membranous lupus nephritis (MLN)
  • Tacrolimus

ASJC Scopus subject areas

  • Nephrology

Cite this

Maruyama, M., Yamasaki, Y., Sada, K., Sarai, A., Ujike, K., Maeshima, Y., ... Makino, H. (2006). Good response of membranous lupus nephritis to tacrolimus. Clinical Nephrology, 65(4), 276-279.

Good response of membranous lupus nephritis to tacrolimus. / Maruyama, M.; Yamasaki, Y.; Sada, Kenei; Sarai, A.; Ujike, K.; Maeshima, Y.; Nakamura, Y.; Sugiyama, Hitoshi; Makino, Hirofumi.

In: Clinical Nephrology, Vol. 65, No. 4, 04.2006, p. 276-279.

Research output: Contribution to journalArticle

Maruyama, M, Yamasaki, Y, Sada, K, Sarai, A, Ujike, K, Maeshima, Y, Nakamura, Y, Sugiyama, H & Makino, H 2006, 'Good response of membranous lupus nephritis to tacrolimus', Clinical Nephrology, vol. 65, no. 4, pp. 276-279.
Maruyama M, Yamasaki Y, Sada K, Sarai A, Ujike K, Maeshima Y et al. Good response of membranous lupus nephritis to tacrolimus. Clinical Nephrology. 2006 Apr;65(4):276-279.
Maruyama, M. ; Yamasaki, Y. ; Sada, Kenei ; Sarai, A. ; Ujike, K. ; Maeshima, Y. ; Nakamura, Y. ; Sugiyama, Hitoshi ; Makino, Hirofumi. / Good response of membranous lupus nephritis to tacrolimus. In: Clinical Nephrology. 2006 ; Vol. 65, No. 4. pp. 276-279.
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