achilles
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A 28-year-old woman is diagnosed with lupus nephritis, World Health Organization (WHO) type IV. She has a malar rash, diffuse arthritis, and edema. Her blood pressure is 190/110 mm Hg. Her creatinine is 2.1 mg/dL with a blood urea nitrogen of 28 mg/dL. Her urine reveals 25 red blood cells per hpf, and 3+ protein. One red blood cell cast is seen. A 24-hour urine collection reveals a protein of 11 grams with a creatinine of 1 gram. Which of the following would be the most appropriate management?
A. Oral azathioprine
B. Oral cyclophosphamide
C. Oral gold
D. Oral prednisone
E. Pulse IV cyclophosphamide
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| babli
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E. Pulse IV cyclophosphamide
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| msyamp
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Actually type IV are treated with oral prednisolone. or IV prednisolone. then if that does not releive we go for Cyclophosphamainde I.V. But here??!!! IF we can manage Hypertension with ACE inhibitors it is ok if we still go for Prednisolone oral.
D. oral prednisolone. I go for it come what may I may be wrong though
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| sunny2
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D.Oral prednisone
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| yasmeen
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PREDNISOLONE
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| achilles
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the answer is E.
The most effective treatment for aggressive systemic lupus erythematosus with nephritis is pulse cyclophosphamide. This has been shown to be the best agent to treat type IV lupus nephritis.
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