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Folia Medica Indonesiana

ISSN 0303-7932

Vol. 51 / No. 1 / Published : 2015-01

TOC : 8, and page :40 - 44

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Original Article :

Megadose methylprednisolone on total lymphocyte count and disease activity in systemic lupus erythematosus (sla)

Author :

  1. Jainuri Erik P*1
  2. Arofa Idha*2
  3. Bagus PP Suryana*3
  4. Yulistiani*4
  1. Mahasiswa Fakultas Farmasi
  2. Department of Pharmacy, Dr. Saiful Anwar Hospital, Malang
  3. Division of Rheumatology and Immunology, Internal Department, Dr Saiful Anwar Hospital, Universitas Brawijaya, Malang
  4. Dosen Fakultas Farmasi

Abstract :

Megadose methylprednisolone, called pulse therapy, is the administration of very high doses of methylprednisolone givenintravenously for three days. Although many studies have demonstrated the efficacy and safety of pulse therapy in SLE, there is stillno clearly parameter which is shown the outcome of pulse methylprednisolone therapy. Some studies suggest that lymphopenia itselfis associated with disease activity in lupus. Therefore, the alteration of total lymphocyte count due to pulse methylprednisolonetherapy should be considered as an index of residual disease activity of SLE, and a potential parameter of treatment efficacy of pulsemethylprednisolone therapy. The aim of this study is to determine the effect of pulse methylprednisolone therapy on total lymphocytecount and disease activity in systemic lupus erythematosus (SLE) assessed by MEX SLEDAI method. A cross-sectional, observationalprospective study was conducted to determine the effect of pulse methylprednisolone therapy in total lymphocyte count and diseaseacitivity of SLE. Patients who met criteria were given megadose methylprednisolone (500 – 1000 mg) therapy for three days. Toevluate the efficacy, total lymphocyte count was measure at before and 24 hours after 1st, 2nd, and 3rd therapy, whereas the MEXSLEDAI score was only measured at before and after 3rd therapy. The study comprised 10 patients with acute severe manifestationof SLE. At 24 hours after 3rd pulse therapy, megadose methylprednisolone was associated with significant reduce both totallymphocyte count (Δ 602.20 ± 395.65 cells/mm3) (p=0.013) and MEX SLEDAI score (Δ 3.50 ± 4.04) (p=0.035). There is nosignificant correlation was observed between alteration of total lymphocyte count and MEX SLEDAI score after the therapy wasgiven (p=0.248). In conclusion, three days after treatment of megadose methylprednisolone showed significant different in reducingboth total lymphocyte count and disease activity in SLE. But there is no relationship between both of them. (FMI 2015;51:40-44)

Keyword :

Pulse Methylprednisolone Therapy, SLE, total Lymphocyte Count, MEX SLEDAI,


References :

  1. Datta S and Sarvetnick N , (2009). Lymphocyte proliferation in immune-mediated diseases. 30, 430-438 : Trends Immunol
  2. Faddah S, Elwakd M, Aboelenein A, Hussein M , (2014). Lymphopenia and systemic lupus erythematosus, a preliminary study: correlation with clinical manifestations, disease activity and damage indices. 36, 125–130 : The Egyptian Rheumatologist


   


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