Clinical efficacy of plasma exchange in systemic lupus erythematosus during pregnancy

作者：Fen Zhang, B H Zhang, Ru Fan, Ting Cheng, Xiaorong Hu, Yuqing Liu, Xing Cen, Yu‐Jie Bu, Jianping Cao, F Chen, Junwei Chen · 发表于：Immunity Inflammation and Disease · 年份：2023 · DOI：10.1002/iid3.1041 · 被引用次数：6 · 研究领域：Systemic Lupus Erythematosus Research、Pregnancy and Medication Impact、Pregnancy and preeclampsia studies

OBJECTIVE: To investigate the clinical efficacy of plasma exchange (PE) with or without prednisone and hydroxychloroquine (HCQ) for the treatment of systemic lupus erythematosus (SLE) during pregnancy. METHODS: The clinical characteristics of 14 pregnant women with SLE admitted to our hospital were retrospectively analyzed, including 7 only treated with prednisone and HCQ (non-PE group) as well as 7 combined PE (PE group). The delivery situations of 14 patients were recorded. Data like erythrocyte sedimentation rate (ESR), urine protein, platelet count, and SLEDAI scores were compared between two groups before treatment and 3, 6, and 12 months after delivery. RESULTS: Three patients in the non-PE group ended in miscarriage while all patients in the PE group were delivered successfully. Eleven successfully delivered fetuses in the two groups were healthy, and the Apgar scores were over 8. The ESR of the PE group was significantly lower than that of the non-PE group at 6 and 12 months after delivery, while there was no statistical difference in ESR between the two groups before treatment and 3 months after delivery. The ESR and urine protein were significantly higher in the non-PE group at months 3, 6, and 12 postpartum. There was a significant decrease in disease activity postpartum in the PE group compared to predelivery disease activity. The change in platelet counts between the two groups significantly increased over time in the PE group, while SLEDAI scores decreased. CONC...