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Abstract：
Systemic lupus erythematosus (SLE) is a chronic multiorgan autoimmune disease with a wide range of clinical manifestations and a characteristic renal involvement leading to proteinuria. There remains an unmet need in SLE disease management as standard treatments including anti-inflammatory drugs, corticosteroids, antimalarial agents, and immunosuppressant therapies are not always effective in moderating disease activity. We report a 41-year-old Caucasian female patient with a 12-year history of SLE complicated by debilitating nocturnal fevers and WHO Class IV lupus nephritis who for years was refractory to standard therapies but improved dramatically with canakinumab, an interleukin-1β (IL-1β)antagonist. This is the first case of the use of canakinumab in SLE. The standard interventions demonstrated no significant impact on her proteinuria (>3 g/24 h), joint complaints, and nocturnal fevers. Additionally, her anti-dsDNA levels remained elevated, and her kidney function did not improve significantly. In contrast, the introduction of canakinumab provided a rapid reduction in nocturnal fevers within 6 weeks (i.e. decreased in frequency by 90%). Her proteinuria has also dropped from 3.5 g/24 h to 0.274 g/24 h, and her prednisone has been tapered and discontinued. In addition, her renal function has improved with an average glomerular filtration rate (GFR) level of 84.14 ± 7.56. There has also been a significant decrease in both erythrocyte sedimentation rate (ESR) and anti-dsDNA levels compared with the previous treatments. We report that canakinumab could potentially represent the next step in SLE patients\' treatment who have failed conventional therapies or who are intolerant to them. In this case, the addition of canakinumab facilitated the tapering and ultimately discontinuing of corticosteroids. This case represents the first successful use of canakinumab in the treatment of refractory fevers and diffuse proliferative glomerulonephritis in SLE.
Canakinumab in refractory systemic lupus erythematosus: A successful case report for managing recurrent fevers and kidney inflammation Systemic lupus erythematosus (SLE) is a long-term autoimmune disease that affects multiple organs in the body, including the kidneys. Some patients with SLE do not respond well to standard treatments, such as anti-inflammatory drugs and immunosuppressants. This case report describes a 41-year-old woman with SLE and severe kidney inflammation who did not improve with conventional therapies. However, when she was given canakinumab, a medication that blocks a protein called IL-1β, her symptoms improved significantly. Within six weeks, her fevers decreased by 90%, her kidney function improved, and her protein levels in the urine dropped. This case suggests that canakinumab may be a promising treatment option for SLE patients who do not respond to or cannot tolerate traditional therapies. It also shows that canakinumab helped reduce the need for corticosteroids in this patient. This is the first successful use of canakinumab to treat refractory fevers and kidney inflammation in SLE patients.
Canakinumab in refractory systemic lupus erythematosus: A successful case report for managing recurrent fevers and kidney inflammation Systemic lupus erythematosus (SLE) is a long-term autoimmune disease that affects multiple organs in the body, including the kidneys. Some patients with SLE do not respond well to standard treatments, such as anti-inflammatory drugs and immunosuppressants. This case report describes a 41-year-old woman with SLE and severe kidney inflammation who did not improve with conventional therapies. However, when she was given canakinumab, a medication that blocks a protein called IL-1β, her symptoms improved significantly. Within six weeks, her fevers decreased by 90%, her kidney function improved, and her protein levels in the urine dropped. This case suggests that canakinumab may be a promising treatment option for SLE patients who do not respond to or cannot tolerate traditional therapies. It also shows that canakinumab helped reduce the need for corticosteroids in this patient. This is the first successful use of canakinumab to treat refractory fevers and kidney inflammation in SLE patients.
摘要：
系统性红斑狼疮（SLE）是一种慢性多器官自身免疫性疾病，临床表现广泛，肾脏受累导致蛋白尿。作为包括抗炎药在内的标准治疗，SLE疾病管理仍有未满足的需求。皮质类固醇,抗疟药，和免疫抑制剂疗法并不总是有效的调节疾病活动。我们报告了一名41岁的白人女性患者，有12年的SLE病史，伴有衰弱的夜间发烧和WHOIV类狼疮性肾炎，多年来对标准疗法难以治疗，但使用canakinumab可显着改善。白细胞介素-1β（IL-1β）拮抗剂。这是在SLE中使用canakinumab的第一例。标准干预措施对她的蛋白尿（>3g/24h）没有显着影响，联合投诉，和夜间发烧。此外,她的抗dsDNA水平仍然升高,肾功能没有明显改善.相比之下,canakinumab的引入使夜间发烧在6周内迅速减少(即频率降低90%).她的蛋白尿也从3.5克/24小时降至0.274克/24小时，她的泼尼松已经逐渐减少并停用。此外,肾功能改善,平均肾小球滤过率(GFR)为84.14±7.56.与先前的治疗相比,红细胞沉降率(ESR)和抗dsDNA水平也显著降低。我们报告说，canakinumab可能代表传统疗法失败或对其不耐受的SLE患者的下一步治疗。在这种情况下,加用canakinumab促进了皮质类固醇的逐渐减少和最终停用.该病例代表了canakinumab首次成功治疗SLE的难治性发烧和弥漫性增生性肾小球肾炎。
Canakinumab治疗难治性系统性红斑狼疮：治疗复发性发烧和肾脏炎症的成功病例报告系统性红斑狼疮（SLE）是一种长期的自身免疫性疾病，会影响体内多个器官，包括肾脏.一些SLE患者对标准治疗反应不佳，如抗炎药和免疫抑制剂。该病例报告描述了一名41岁的女性，患有SLE和严重的肾脏炎症，使用常规疗法没有改善。然而,当她服用canakinumab时，一种阻断IL-1β蛋白的药物，她的症状明显改善。六周内,她的发烧减少了90%,她的肾功能改善了,尿液中的蛋白质含量下降了.这种情况表明，对于对传统疗法没有反应或不能耐受的SLE患者，canakinumab可能是一种有希望的治疗选择。它还表明canakinumab有助于减少该患者对皮质类固醇的需求。这是首次成功使用canakinumab治疗SLE患者的难治性发烧和肾脏炎症。
Canakinumab治疗难治性系统性红斑狼疮：治疗复发性发烧和肾脏炎症的成功病例报告系统性红斑狼疮（SLE）是一种长期的自身免疫性疾病，会影响体内多个器官，包括肾脏.一些SLE患者对标准治疗反应不佳，如抗炎药和免疫抑制剂。该病例报告描述了一名41岁的女性，患有SLE和严重的肾脏炎症，使用常规疗法没有改善。然而,当她服用canakinumab时，一种阻断IL-1β蛋白的药物，她的症状明显改善。六周内,她的发烧减少了90%,她的肾功能改善了,尿液中的蛋白质含量下降了.这种情况表明，对于对传统疗法没有反应或不能耐受的SLE患者，canakinumab可能是一种有希望的治疗选择。它还表明canakinumab有助于减少该患者对皮质类固醇的需求。这是首次成功使用canakinumab治疗SLE患者的难治性发烧和肾脏炎症。
