Intravenous cyclophosphamide treatment for systemic lupus erythematosus with severe autonomic disorders confirmed by head-up tilt table test: A case series

Author:

Umeda Masataka123ORCID,Kawano Hiroaki4,Endo Yushiro1,Takatani Ayuko1,Koga Tomohiro1,Ichinose Kunihiro1,Nakamura Hideki1,Mukaino Akihiro5,Higuchi Osamu6,Nakane Shunya5,Maeda Takahiro3,Kawakami Atsushi1

Affiliation:

1. Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

2. Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan

3. Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

4. Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

5. Department of Molecular Neurology and Therapeutics, Kumamoto University Hospital, Kumamoto, Japan

6. Department of Clinical Research, Nagasaki Kawatana Medical Center, Kawatana, Japan

Abstract

ABSTRACT Autonomic disorders are common in patients with systemic lupus erythematosus (SLE), but the therapeutic strategy and methods for evaluating the effects of therapy have not been established. We describe the three cases of SLE patients who developed severe autonomic disorders as demonstrated by the head-up tilt table test (HUT). All three patients were treated by intensive immunosuppressive treatments including intravenous cyclophosphamide (IVCY); their HUT results all became negative. Our cases suggest that IVCY treatment can be a good therapeutic option for severe autonomic disorders in SLE patients. The HUT is a useful objective method for the diagnosis of and the evaluation of longitudinal therapeutic effects on autonomic disorders in SLE patients with orthostatic intolerance.

Publisher

Oxford University Press (OUP)

Subject

General Medicine

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