ArticleIn vivo (Athens, Greece)
Longitudinal Immunophenotypic Changes in Refractory Lupus Nephritis After B-cell Depletion: A 25-year Case Study.
Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
aimLong-term management of systemic lupus erythematosus (SLE) requires a persistent balance between intensive immunosuppression and the prevention of opportunistic infections. This is particularly challenging in patients with a multi-decade disease history and evolving renal pathology. CASE REPORT: We report a female patient diagnosed with SLE in 2001 (Age 25). Following biopsy-proven class IV lupus nephritis (LN) in 2003, she achieved a remarkable 20-year clinical remission after receiving a 12-cycle induction regimen of intravenous cyclophosphamide (IV-CYC). In December 2025, the patient presented with a severe refractory flare-up; a repeat renal biopsy revealed progression to mixed Class IV+V LN. Management included steroid pulse therapy and rituximab (RTX) infusion. The post-RTX clinical course was complicated by
conclusionThis case highlights the long-term efficacy of IV-CYC induction and the complexities of managing refractory LN flares. It underscores the critical necessity of vigilant monitoring and prompt intervention for multi-microbial opportunistic infections following intensive B-cell depletion therapy in long-standing SLE patients.
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