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Synchronization of Plasmapheresis and Pulse Cyclophosphamide in Severe Systemic Lupus Erythematosus

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▸Requests for reprints should be addressed to Johann O. Schroeder, M.D.; 2nd Department of Internal Medicine, Christian-Albrechts University, Metzstrasse 53; D-2300 Kiel 1, Federal Republic of Germany.

© 1987 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1987;107(3):344-346. doi:10.7326/0003-4819-107-2-344
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Two patients with severe systemic lupus erythematosus, who had not responded to conventional therapy, were treated with plasmapheresis and subsequent pulse cyclophosphamide. This approach uses the plasmapheresis-induced proliferation of pathogenic clones for partial clonal deletion by giving large doses of cytotoxic drugs during the assumed period of increased B-cell vulnerability. Both patients had a rapid and distinct improvement in clinical symptoms and laboratory parameters, including the control of a life-threatening case of lupus pneumonitis. Their conditions were stabilized by giving low-dose cyclophosphamide for the next 6 months. At 14-month follow-up, there were no clinical signs of relapse.





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