We report the case of a 19-year-old woman with progressive proliferative lupus nephritis (LN) class III after induction and maintenance therapy with mycophenolate mofetil (MMF). Despite a satisfying clinical improvement proteinuria progressed under this medication. We treated the patient with additional belimumab after discussing other options. Following treatment with belimumab, proteinuria rapidly improved to almost normal levels and clinical remission lasted. Belimumab might hold promise for this indication.
Dall'EraMWofsyDClinical features of SLE. In: FiresteinGSBuddRCGabrielSEMcInnesIBO'DellJR (eds). Kelley's Textbook of Rheumatology, Philadelphia: WB Saunders, 2013, pp. 1283–1303.
2.
WeeningJJD'AgatiVDSchwartzMM. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney Int2004; 65: 521–530.
3.
HahnBHMcMahonMAWilkinsonA. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis. Arthritis Care Res (Hoboken)2012; 64: 797–808.
HochbergMC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1997; 40: 1725–1725.
6.
Christopher-StineLSiednerMLinJ. Renal biopsy in lupus patients with low levels of proteinuria. J Rheumatol2007; 34: 332–335.
7.
NavarraSVGuzmanRMGallacherAE. Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: A randomised, placebo-controlled, phase 3 trial. Lancet2011; 377: 721–731.
8.
ManziSSanchez-GuerreroJMerrillJT. Effects of belimumab, a B lymphocyte stimulator-specific inhibitor, on disease activity across multiple organ domains in patients with systemic lupus erythematosus: Combined results from two phase III trials. Ann Rheum Dis2012; 71: 1833–1838.
9.
van VollenhovenRFPetriMACerveraR. Belimumab in the treatment of systemic lupus erythematosus: High disease activity predictors of response. Ann Rheum Dis2012; 71: 1343–1349.
