Treatment of class II lupus nephritis with combination therapy of mycophenolic acid and corticosteroid; a case report

Abstract

Lupus nephritis (LN) is one of the most serious manifestations of systemic lupus erythematosus (SLE). Despite available guidelines recommendations on appropriate therapeutic agents, up to one-third of LN patients still do not meet expected response to initial corticosteroid or immunosuppressive treatment. We report a 17-year-old Indonesian female who was diagnosed LN with persistent proteinuria manifestations. Renal biopsy was suggestive of class II LN. Corticosteroid was given for a month without therapeutic response, and the patient was given combination of moderate dose methylprednisolone and mycophenolic acid resulted in complete remission after nine months therapy. Despite the existing guidelines, choices of LN treatment might be individual depends on disease severity (clinical, laboratory and histopathological findings) and demographic factors. The combination of mycophenolic acid and corticosteroid might be better option than high dose corticosteroid to treat class II LN for minimizing the adverse event of corticosteroid.