ABSTRACT
OBJECTIVE: To determine the therapeutic effect of mycophenolate mofetil (MMF) and the adverse effects associated with MMF in patients with lupus nephritis. METHODS: We studied 51 patients with lupus nephritis, who had received MMF for more than 3 months. The efficacy was assessed as renal profiles, SLE disease activity index (SLEDAI), serum cytokine levels and oral corticosteroid dose. The adverse effects were evaluated by medical records and interview of each patient. Serum cytokine levels of IL-10, IFN-alpha and IFN-gamma were determined by sandwich ELISA at starting MMF and at 12 months after MMF therapy. RESULTS: MMF treatment resulted in complete remission 52.9%, partial remission 25.5% and treatment failure 21.6%. There was no difference of MMF efficacy between WHO class IV and V in 32 patients with biopsy-proven nephritis. The renal profiles and parameters for disease activity were improved, as assessed by increased serum albumin and C3 level, decreased proteinuria, cyturia, ESR, SLEDAI and oral corticosteroid doses. Serum IL-10 decreased after MMF therapy in class IV group, but not in class V group. Serum IFN-alpha, IFN-gamma level and IFN-gamma/IL-10 ratio also tended to decrease after MMF therapy. GI troubles including dyspepsia, nausea, vomiting and diarrhea were the most common adverse effects of MMF as 54.9%, followed by hair loss, leukopenia, anemia, infection, but there was no serious adverse effect. CONCLUSION: MMF is an effective and well tolerable immunosuppressant for both class IV and V lupus nephritis, even not responding or intolerable to conventional immunosuppressive therapy.
Subject(s)
Humans , Anemia , Cytokines , Diarrhea , Dyspepsia , Enzyme-Linked Immunosorbent Assay , Hair , Interleukin-10 , Leukopenia , Lupus Erythematosus, Systemic , Lupus Nephritis , Medical Records , Nausea , Nephritis , Proteinuria , Serum Albumin , Treatment Failure , VomitingABSTRACT
OBJECTIVE: To evaluate clinical significance of interleukin 15 (IL-15) in patients with Behcet's disease (BD). METHODS: Serum samples were obtained from 31 patients with BD and 29 healthy controls. BD patients were divided into active and inactive group according to the presence of clinical manifestations on the day of sampling. Serum levels of IL-15 and IL-8 were measured by sandwich enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum levels of IL-15 and IL-8 were significantly higher in BD patients than in healthy controls (117.2+/-26.2 pg/ml versus 51.8+/-15.4 pg/ml, p<0.01, 287.7+/-100.9 pg/ml versus 138.5+/-17.2 pg/ml, p<0.01, respectively). There was a significant correlation between serum levels of IL-15 and IL-8 IL-15 levels compared with those without it (161.1+/-68.8 pg/ml versus 96.4+/-3 4 . 8pg/ml, p<0.05). Serum levels of IL-15 and IL-8 tended to be higher in active group than in inactive group, but didn't reach statistical significance. CONCLUSION: Serum level of IL-15 was elevated in patients with BD, especially those with uveitis, but it did not seem to be useful as a marker of disease activity in BD.
Subject(s)
Humans , Enzyme-Linked Immunosorbent Assay , Interleukin-15 , Interleukin-8 , Interleukins , UveitisABSTRACT
OBJECTIVE: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). METHODS: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary? Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. RESULTS: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6), Streptococcus pneumoniae (n=2), coagulase negative Staphylococci (n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Enterococcus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone > 0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. CONCLUSION: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
Subject(s)
Female , Humans , Bacillus , Bacteremia , Causality , Coagulase , Enterococcus faecalis , Listeria monocytogenes , Logistic Models , Lupus Erythematosus, Systemic , Lupus Nephritis , Medical Records , Mirabilis , Odds Ratio , Pneumonia , Retrospective Studies , Salmonella , Streptococcus pneumoniae , Streptococcus pyogenes , Thrombocytopenia , Viridans StreptococciABSTRACT
OBJECTIVE: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). METHODS: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary? Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. RESULTS: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6), Streptococcus pneumoniae (n=2), coagulase negative Staphylococci (n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Enterococcus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone > 0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. CONCLUSION: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
Subject(s)
Female , Humans , Bacillus , Bacteremia , Causality , Coagulase , Enterococcus faecalis , Listeria monocytogenes , Logistic Models , Lupus Erythematosus, Systemic , Lupus Nephritis , Medical Records , Mirabilis , Odds Ratio , Pneumonia , Retrospective Studies , Salmonella , Streptococcus pneumoniae , Streptococcus pyogenes , Thrombocytopenia , Viridans StreptococciABSTRACT
No abstract available.