Successful treatment of a refractory case of systemic lupus erythematosus with tacrolimus and mycophenolate mofetil

DOI
  • Ito Tomoki
    First Department of Internal Medicine, Kansai Medical University
  • Ozaki Yoshio
    First Department of Internal Medicine, Kansai Medical University Deptartment of Rheumatology and Clinical Immunology, Hirakata Hospital, Kansai Medical University
  • Tanaka Akihiro
    First Department of Internal Medicine, Kansai Medical University Deptartment of Rheumatology and Clinical Immunology, Hirakata Hospital, Kansai Medical University
  • Shimamoto Keiko
    First Department of Internal Medicine, Kansai Medical University
  • Amuro Hideki
    First Department of Internal Medicine, Kansai Medical University
  • Kawakami Katsuyuki
    First Department of Internal Medicine, Kansai Medical University Deptartment of Rheumatology and Clinical Immunology, Hirakata Hospital, Kansai Medical University
  • Son Yonsu
    First Department of Internal Medicine, Kansai Medical University Deptartment of Rheumatology and Clinical Immunology, Hirakata Hospital, Kansai Medical University
  • Nomura Shosaku
    First Department of Internal Medicine, Kansai Medical University

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Other Title
  • タクロリムスとミコフェノール酸モフェチルの併用療法が奏功した多剤抵抗性の全身性エリテマトーデスの一例

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Here, we report a case of effective treatment of an intractable systemic lupus erythematosus (SLE) using mycofenol mofetil and tacrolimus. In this case, the SLE activity was resistant to single immunosuppressive drug therapy such as azathioprin, tacrolimus, cyclosporin A, mycofenol mofetil and prednisolone. Moreover, although she was also treated with 5courses of corticosteroid pulse therapy, double membrane filtration plasmapheresis, and plasma exchange, none of these were effective. After informed consent, treatment using a combination of mycofenol mofetil and tacrolimus together with prednisolone was started. After two months, proteinuria, edema, hypocomplementemia, and alopecia were improved. Thus, the combination therapy including mycofenol mofetil and tacrolimus should be considered as a treatment for SLE, if it is intractable to standard treatment.

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