SYNCHRONIZING THERAPY WITH PLASMAPHERESIS AND CYCLOPHOSPHAMIDE OF PROGRESSIVE SLE WITH RENAL-FAILURE

12 patients with rapidly progressive systemic lupus erythematosus (SLE ) combined with renal failure were treated for 6 months according to t he following scheme: 3 consecutive procedures of plasmapheresis (60 ml /kg x 3), 3 consecutive pulse doses of cyclophosphamide (400 mg/m(2) x 3), 3 prednisolone infusions (2 mg/kg x 3), oral cyclophosphamide (10 0-250 mg/day) and prednisolone (0.5 mg/kg with subsequent dose reducti on). Dose of the drugs was controlled by blood leukocyte count and cre atinine clearance. The patients were included in the trial in the pres et time. All the patients had active SLE (33.5+-2.7 U according to SLA M). 75, 25, 58.3, 33.4, 8.3% of patients had mixed, nephrotic, mesangi ocapillary, mesangioproliferative, membraneous nephritis, respectively . 26 weeks of the treatment produced a response in 83.3% of the patien ts. The disease activity lowered to 12.8+-2.9 U. Four-year survival re ached 81%. Cytopenia developed in 25% of patients, deep hemopoiesis de pression was not observed. Septic candidiasis arose in one woman on th e third year of the follow-up. Clinical validity of the above method i s stated in severe SLE.