[T-activin in multimodal treatment of systemic lupus erythematosus in children]. / Taktivin v kompleksnoi terapii sistemnoi krasnoi volchanki u detei.

The efficacy of taktivin was examined by comparison of the time-course of changes in cellular immunity, the course of the underlying disease and the incidence of infectious complications in two groups of patients with systemic lupus erythematosus (SLE). The first group included 49 patients aged 8 to 15 years receiving taktivin, the second one 34 children of the same age not given immunomodulatory therapy. The morphofunctional status of the thymus was studied in 9 cases on autopsy. The prolonged treatment with taktivin (for 4 weeks and over) resulted in an increase of the number of patients with the improved health status and reduction of SLE activity, in a rise of the content of serum thymic factor, activation of the processes of T lymphocyte differentiation, in an increase of the lymphocyte count in patients with secondary infection, activation of phagocytosis, rise of bactericidal activity of the serum, which entailed the elimination and prevention of the development of secondary infectious complications. Taktivin promotes the normalization of the thymic structure and exerts a replacement effect.

[Synchronization of plasmapheresis and pulse therapy in the complex treatment of children with highly active glomerulonephritis]. / Sinkhronizatsiia plazmafereza i lul's-terapii v kompleksnom lechenii vysokoaktivnogo glomerulonefrita u detei.

To suppress the activity of glomerulonephritis, lupus and primary chronic mixed one, 13 children received plasmapheresis synchronously with pulse therapy with cyclophosphamide or prednisolone. Plasmapheresis was carried out daily for 3 days. Six hours after the last session and on days 4 and 5 of the treatment pulse therapy was provided, followed by conventional intake of prednisolone per os in combination with azathioprine or cyclophosphamide. Beneficial therapeutic results were obtained in 10 patients within 3 to 6 weeks. The effect turned out insufficient in a patient with associated systemic lupus erythematosus, and rapid-progressing nephritis and in a child with primary chronic glomerulonephritis of the mesangiocapillary type with fibroplastic transformation and persistent nephrotic syndrome. No therapeutic effect was attained in a patient with focal segmental glomerulosclerosis running its course with long persistent nephrotic syndrome.

[The functional morphology of the thymus in systemic lupus erythematosus and its characteristics during immunodepressive and immunostimulating therapies]. / Funktsional'naia morfologiia timusa pri sistemnoi krasnoi volchanke, ee osobennosti pri immunodepressivnoi i immunostimuliruiushchei terapii.

Functional morphology of thymus is studied in 10 autopsy cases of systemic lupus erythematosus (SLE) in patients of 8 to 30 years, treated with high doses of glucocorticosteroids (GCS) alone or in combination with tactivin or without immunomodulating therapy. Manifestations of SLE are interstitial thymitis and pronounced thymus parenchyma atrophy which is present regardless of therapy. In the absence of the therapy with high doses of GCS, increase of perivascular spaces of thymus lobules with the appearance in these spaces of lymphoid follicles results in the false increase of the thymus volume and weight simulating its hyperplasia. GCS therapy enhances parenchymal atrophy and decreases the size of perivascular spaces. The use of tactivin against this background results in some normalization of thymic structure enhancing the lymphocyte proliferative activity. Effect of tactivin is masked by a more powerful GCS therapy.

[Preliminary results of studying the effectiveness of hemosorption in the complex treatment of children with lupus nephritis]. / Predvaritel'nye rezul'taty izucheniia éffektivnosti gemosorbtsii v kompleksnom lechenii detei s volchanochnym nefritom.

Hemosorption was employed in multi-modality treatment of 12 children aged 10-15 years with lupus nephritis. Of these, 5 patients suffered from nephritis associated with the nephrotic syndrome (NS), 4 patients had active pronounced nephritis without the NS, and 3 patients presented with latent nephritis. One case was characterized by transitory renal failure in the acute phase while 3 cases by chronic renal failure. Hemosorption produced a beneficial effect on the renal process and on electrolyte balance. The long-term observation over the patients evidences a short-term effect of hemosorption. After the attainment of that effect the further disease course depended on the adequacy of the conservative therapy administered to the patients with lupus nephritis.