Xiaojun Li, Meijing Li, Rongkuan Li, Qin Yao, Jie Sheng
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Efficacy of Belimumab for Active Lupus Nephritis in a Young Asian Man with Latent Pulmonary Tuberculosis: A Case Report.
Introduction: Managing active lupus nephritis (LN) in the presence of latent tuberculosis (TB) presents a significant treatment challenge. Traditional treatment with glucocorticoids combined with mycophenolic acid carries a high risk of triggering pulmonary TB infection in LN patients. In this report, we discuss a novel approach using belimumab in combination with rapidly tapering corticosteroids to treat a patient with active class IV and V LN and latent TB.
Case presentation: A 24-year-old Chinese male was diagnosed with active class IV and V LN and latent TB. He underwent induction therapy with a combination of belimumab, rapidly tapering methylprednisolone and mycophenolate mofetil. After 18 months of belimumab therapy, the patient's blood albumin levels and kidney function normalized, with 24-h urinary protein levels stabilizing between 500 mg and 725 mg. Notably, there was no recurrence of TB.
Conclusion: This case demonstrates that the combination of belimumab and rapid corticosteroid tapering effectively reduced the duration of high-dose glucocorticoid therapy, highlighting the efficacy and safety of belimumab in managing LN with latent TB.
期刊介绍:
This peer-reviewed online-only journal publishes original case reports covering the entire spectrum of nephrology and dialysis, including genetic susceptibility, clinical presentation, diagnosis, treatment or prevention, toxicities of therapy, critical care, supportive care, quality-of-life and survival issues. The journal will also accept case reports dealing with the use of novel technologies, both in the arena of diagnosis and treatment. Supplementary material is welcomed.