Ciclosporin (CyA) and Therapeutic Plasma Exchange in Steroid-resistant SLE

Systemic lupus erythematosus (SLE) may give rise to an extremely variable symptomatology with different clinical pictures ranging from an acute attack with high fever, anaemia, leucocytopenia and thrombocytopenia, arthritis, exanthema and polyserositis to the isolated involvement of organs including the kidneys, bone marrow or joints. Over recent years, aggressive therapy has ensured a continual increase of survival rates. The 5- and 10-year survival rates have been given as 75% and 60% for SLE with nephrotic syndrome and as 88% and 79% for other forms of SLE [9]. In addition to immunosuppressive therapy with cyclophosphamide, azathioprine and steroids [4], more recently the prognosis has been improved by administering high doses of prednisone and by combining therapeutic plasma exchange (TPE) with immunosuppression.