Early treatment does indeed alter the prognosis. I have gathered some
online material that I hope you will find useful.
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"In most patients today, there is a gratifying response to early
treatment, followed by relatively quiescent disease under continuing
immunosuppression that can be tapered out eventually without further
relapse. Another common pattern is the patient rendered quiescent who
suddenly relapses. The frequency and intensity of relapses depend not
only on the underlying disease, but on the intensity and duration of
immunosuppression. Since lupus is a multisystem disease, the outlook
does not of course depend only on what happens to renal function,
especially now that this is treatable by dialysis and
transplantation."
Journal of the American Society of Nephrology: Lupus Nephritis.
http://www.jasn.org/cgi/content/full/10/2/413
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"Prompt therapy with prednisone and immunosuppressive agents in lupus
nephritis has a beneficial effect on longterm prognosis."
PubMed: The benefit of early treatment with immunosuppressive agents
in lupus nephritis. (abstract)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=7869308&dopt=Abstract
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"We conclude that treatment with 250 mg CsA/kg/week prevents the
development of glomerulonephritis and glomerulosclerosis in this model
of lupus nephritis, if started before the onset of proteinuria."
PubMed: Prevention of glomerulosclerosis by early cyclosporine
treatment of experimental lupus nephritis. (abstract)
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=7700025&dopt=Abstract
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Systemic lupus progresses with ups and downs. Periods of serious
exacerbations may alternate with periods of low disease activity, in
which one may even discontinue taking medication. The patient is then
said to be in remission. After menopause, lupus is likely to disappear
spontaneously.
Life expectancy has increased greatly over the last 40 years and
statistically almost equals a normal life span with 93 % of all
patients surviving ten years after diagnosis. This improvement is due
to early diagnosis and better use of medication. Even lupus nephritis
can be reversed if treatment follows immediately and intensively.
CIB-liga: Lupus Erythematosus
http://www.cibliga.com/en/lupus.html
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"Long-term outcomes in patients with severe lupus nephritis (LN) have
improved greatly over the past two decades. In particular, outcome has
improved among patients who have class IV biopsies. (Cameron. 1999).
The documented benefits of early treatment of LN have led to a
propensity to treat all patients, regardless of disease severity, as
determined by the World Health Organization (WHO) classification
system."
PeerView Press: Unresolved Clinical and Therapeutic Issues
http://ww3.peerviewpress.com/peerview.nsf/release/042001_sec1_Unre.html
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Improved clinical outcome of lupus nephritis during the past decade:
importance of early diagnosis and treatment... The outcome of patients
with newly diagnosed LN was significantly better between 1990 and 2000
than between 1980 and 1989. Kidney damage and chronic histological
changes at time of diagnosis were significantly less common between
1990 and 2000, which is attributable to earlier diagnosis and
treatment in the later decade."
BMJ Public Health Journals: Improved clinical outcome of lupus
nephritis during the past decade: importance of early diagnosis and
treatment (abstract)
http://ard.bmjjournals.com/cgi/content/abstract/62/5/435
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"In most patients today, there is a gratifying response to early
treatment, followed by relatively quiescent disease under continuing
immunosuppression which can be tapered out eventually without further
relapse. Another common pattern is the patient rendered quiescent who
suddenly relapses. The frequency and intensity of relapses depends not
only on the underlying disease but on the intensity and duration of
immunosuppression. Since lupus is a multisystem disease, the outlook
does not of course depend only upon what happens to renal function,
especially now that this is treatable by dialysis and
transplantation...
Only 10-20% of patients with lupus nephritis now go into end-stage
renal failure, and dialysis and/or transplantation are routinely
available since it was realised in the 1970s that outlook was not
greatly affected by having a systemic disease."
Journal of Nephrology Online: Lupus nephritis: an historical perspective 1968-1998
http://www.sin-italy.org/jnonline/vol12s2/came/came.htm
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My Google search strategy:
Google Web Search: "lupus nephritis" "early treatment"
://www.google.com/search?hl=en&q=%22lupus+nephritis%22+%22early+treatment%22
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I hope this is helpful. Please keep in mind that Google Answers is not
a source of authoritative medical advice; the material I've presented
here is for informational purposes, and is not a substitute for the
services of a qualified medical professional.
If anything is unclear, or if a link does not function, please request
clarification; I'll be glad to offer further assistance before you
rate my answer.
Best wishes,
pinkfreud |
