Cyclophosphamide versus corticosteroids in treatment of lupus nephritis : a clinicopathologic study

Abstract EN

This work aimed to compare the effect of steroids versus cyclophosphamide in treatment of lupus nephritis.

In addition we aim to evaluate the role of renal biopsy in classification, choice of drug regimens and prediction of disease outcome.

The study included 30 patients with documented lupus nephritis (LN) admitted to the department of Internal Medicine, Assiut University Hospital.

Lupus nephritis was diagnosed both clinically and by laboratory investigations including urine analysis, 24 hours-urinary protein, serum creatinine and creatinine clearance, complement C3& C4, LE cell, ANF and percutaneous renal biopsy.

The highest percentage of patients had class IV LN.' Patients were randomly allocated into 2 groups: one receiving prednisolone and the other cyclophosphamide in standard doses for a total of 8-month duration.

The patients were followed-up every month both clinically and biochemically.

Positive clinicopathologic correlations were found in our studied cases.

Clinical and chemical improvement were achieved in 80% of our patients with no statistical difference between either group.

In the non- responsive cases we found that high initial serum creatinine and chronicity and activity indices correlated with poor prognosis.

Our study confirmed a significant role of the WHO classification and NIH indices of LN in the decision concerning the most appropriate treatment and prognostication.