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Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy
OBJECTIVE: To investigate the clinical efficacy of plasma exchange (PE) with or without prednisone and hydroxychloroquine (HCQ) for the treatment of systemic lupus erythematosus (SLE) during pregnancy. METHODS: The clinical characteristics of 14 pregnant women with SLE admitted to our hospital were...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566447/ https://www.ncbi.nlm.nih.gov/pubmed/37904711 http://dx.doi.org/10.1002/iid3.1041 |
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author | Zhang, Fen Zhang, Bing‐Ying Fan, Ru Cheng, Ting Hu, Xiao‐Rong Liu, Yu‐Qing Cen, Xing Bu, Yu‐Jie Cao, Jian‐Ping Chen, Feng‐Wu Chen, Jun‐Wei |
author_facet | Zhang, Fen Zhang, Bing‐Ying Fan, Ru Cheng, Ting Hu, Xiao‐Rong Liu, Yu‐Qing Cen, Xing Bu, Yu‐Jie Cao, Jian‐Ping Chen, Feng‐Wu Chen, Jun‐Wei |
author_sort | Zhang, Fen |
collection | PubMed |
description | OBJECTIVE: To investigate the clinical efficacy of plasma exchange (PE) with or without prednisone and hydroxychloroquine (HCQ) for the treatment of systemic lupus erythematosus (SLE) during pregnancy. METHODS: The clinical characteristics of 14 pregnant women with SLE admitted to our hospital were retrospectively analyzed, including 7 only treated with prednisone and HCQ (non‐PE group) as well as 7 combined PE (PE group). The delivery situations of 14 patients were recorded. Data like erythrocyte sedimentation rate (ESR), urine protein, platelet count, and SLEDAI scores were compared between two groups before treatment and 3, 6, and 12 months after delivery. RESULTS: Three patients in the non‐PE group ended in miscarriage while all patients in the PE group were delivered successfully. Eleven successfully delivered fetuses in the two groups were healthy, and the Apgar scores were over 8. The ESR of the PE group was significantly lower than that of the non‐PE group at 6 and 12 months after delivery, while there was no statistical difference in ESR between the two groups before treatment and 3 months after delivery. The ESR and urine protein were significantly higher in the non‐PE group at months 3, 6, and 12 postpartum. There was a significant decrease in disease activity postpartum in the PE group compared to predelivery disease activity. The change in platelet counts between the two groups significantly increased over time in the PE group, while SLEDAI scores decreased. CONCLUSIONS: The combination of PE and oral prednisone and HCQ is possibly a more effective treatment than oral prednisone and HCQ alone for patients with active SLE during pregnancy. This treatment option reduces pregnancy loss and promotes the patients' postpartum condition to a certain extent. |
format | Online Article Text |
id | pubmed-10566447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105664472023-10-12 Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy Zhang, Fen Zhang, Bing‐Ying Fan, Ru Cheng, Ting Hu, Xiao‐Rong Liu, Yu‐Qing Cen, Xing Bu, Yu‐Jie Cao, Jian‐Ping Chen, Feng‐Wu Chen, Jun‐Wei Immun Inflamm Dis Original Articles OBJECTIVE: To investigate the clinical efficacy of plasma exchange (PE) with or without prednisone and hydroxychloroquine (HCQ) for the treatment of systemic lupus erythematosus (SLE) during pregnancy. METHODS: The clinical characteristics of 14 pregnant women with SLE admitted to our hospital were retrospectively analyzed, including 7 only treated with prednisone and HCQ (non‐PE group) as well as 7 combined PE (PE group). The delivery situations of 14 patients were recorded. Data like erythrocyte sedimentation rate (ESR), urine protein, platelet count, and SLEDAI scores were compared between two groups before treatment and 3, 6, and 12 months after delivery. RESULTS: Three patients in the non‐PE group ended in miscarriage while all patients in the PE group were delivered successfully. Eleven successfully delivered fetuses in the two groups were healthy, and the Apgar scores were over 8. The ESR of the PE group was significantly lower than that of the non‐PE group at 6 and 12 months after delivery, while there was no statistical difference in ESR between the two groups before treatment and 3 months after delivery. The ESR and urine protein were significantly higher in the non‐PE group at months 3, 6, and 12 postpartum. There was a significant decrease in disease activity postpartum in the PE group compared to predelivery disease activity. The change in platelet counts between the two groups significantly increased over time in the PE group, while SLEDAI scores decreased. CONCLUSIONS: The combination of PE and oral prednisone and HCQ is possibly a more effective treatment than oral prednisone and HCQ alone for patients with active SLE during pregnancy. This treatment option reduces pregnancy loss and promotes the patients' postpartum condition to a certain extent. John Wiley and Sons Inc. 2023-10-11 /pmc/articles/PMC10566447/ /pubmed/37904711 http://dx.doi.org/10.1002/iid3.1041 Text en © 2023 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Zhang, Fen Zhang, Bing‐Ying Fan, Ru Cheng, Ting Hu, Xiao‐Rong Liu, Yu‐Qing Cen, Xing Bu, Yu‐Jie Cao, Jian‐Ping Chen, Feng‐Wu Chen, Jun‐Wei Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title | Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title_full | Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title_fullStr | Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title_full_unstemmed | Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title_short | Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
title_sort | clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10566447/ https://www.ncbi.nlm.nih.gov/pubmed/37904711 http://dx.doi.org/10.1002/iid3.1041 |
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