TMA secondary to SLE : rituximab improves overall but not renal survival

Thrombotic microangiopathy (TMA) includes a series of life-threatening disorders. Systemic lupus erythematosus (SLE) is one of the most common acquired causes. To identify predictors of prognosis in patients with TMA secondary to SLE, we conducted a single-center historical study. From January 2013 to June 2016, of 2182 SLE hospitalized patients in the Ren Ji Hospital, a total of 21 consecutive patients with TMA secondary to SLE were identified. The 90-day short-term mortality was 33.3%. The kidney involvement (66.7%) was associated with poor prognosis, while the administration of rituximab (n = 13) was an independent protective factor according to logistic regression analysis. Compared to conventional treatment, i.e., plasma exchange, high-dose glucocorticoids, and intravenous immunoglobulin, the overall survival is significantly higher among patients receiving rituximab add-on (92.2 vs 33.3%, p = 0.0173); however, five out of seven patients with renal involvement in the rituximab group were eventually hemodialysis dependent. Our data indicated that add-on rituximab in the background of conventional therapy may improve the overall but not the renal survival in SLE-TMA patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2018

Erschienen:

2018

Enthalten in:

Zur Gesamtaufnahme - volume:37

Enthalten in:

Clinical rheumatology - 37(2018), 1 vom: 30. Jan., Seite 213-218

Sprache:

Englisch

Beteiligte Personen:

Sun, Fangfang [VerfasserIn]
Wang, Xiaodong [VerfasserIn]
Wu, Wanlong [VerfasserIn]
Wang, Kaiwen [VerfasserIn]
Chen, Zhiwei [VerfasserIn]
Li, Ting [VerfasserIn]
Ye, Shuang [VerfasserIn]

Links:

Volltext

Themen:

4F4X42SYQ6
Immunologic Factors
Journal Article
Rituximab
Systemic lupus erythematosus
Thrombotic microangiopathy
Thrombotic thrombocytopenic purpura

Anmerkungen:

Date Completed 03.08.2018

Date Revised 13.11.2018

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1007/s10067-017-3793-4

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM275288161