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REVIEW ARTICLE
Year : 2009  |  Volume : 4  |  Issue : 4  |  Page : 153-161

Management of lupus nephritis-current perspectives


Department of Medicine, Armed Forces Medical College, Pune, Maharashtra, India

Correspondence Address:
A Jairam
Department of Medicine, Armed Forces Medical College, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


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Systemic lupus is a complex disease that poses a lot of management challenges. The introduction of the International Society of Nephrology (ISN)/RPS classification, which has attempted to bring about a more standard- ized approach to reporting of renal biopsy, plays an important role in the management and prognostication in patients with lupus nephritis (LN). The standard of care for severe proliferative LN had been with pulse cyclophos- phamide. There is emerging evidence for use of mycophenolate mofetil (MMF) as an alternative therapy for both induction and maintenance therapy, especially in milder forms of disease. Many biological response modifiers are in the pipeline. Rituximab is the most studied one in the setting of refractory LN with conflicting evidence. Azathioprine remains a cheaper alternative to the more powerful, expensive therapies and has a role in maintenance immuno- suppression. The optimal management of membranous lupus remains controversial till date.


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