Diagnosis and treatment of lupus nephritis complicated with antiphospholipid syndrome by integrated Chinese and western medicine

doi:10.3877/cma.j.issn.2095-3216.2019.01.002

Abstract

Abstract:

Antiphospholipid syndrome (APS) is a common secondary condition of systemic lupus erythematosus (SLE), and is characterized by the appearance of antiphospholipid antibodies in the circulation, thrombosis, and pathological pregnancy. Patients with lupus nephritis (LN) complicated with APS are prone to more complications, have poor prognosis, and are less sensitive to treatment. Treatments of anticoagulation and/or antiplatelet are the key to the therapy of LN with APS, and plasma exchange has a certain effect in patients with severe APS. In recent years, new drugs and treatments such as rivaroxaban, rituximab, and stem cell transplantation have shown great therapeutic potential. The integrated traditional Chinese and western medicine is another promising treatment, and many famous traditional Chinese medicine doctors believe that the promoting blood circulation and removing blood stasis therapy is effective in treating LN patients complicated with APS. Modern clinical and pharmacological studies have also found the value of traditional Chinese medicine in the treatment of LN complicated with APS.

Key words: Lupus nephritis, Antiphospholipid syndrome, Integrated Chinese and western medicine, Diagnosis and treatment

Shan Mou. Diagnosis and treatment of lupus nephritis complicated with antiphospholipid syndrome by integrated Chinese and western medicine[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2019, 08(01): 6-9.

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References 33

[1]	Cervera R. Antiphospholipid syndrome [J]. Thromb Res, 2017, 151(Suppl 1): S43-S47.
[2]	Miyakis S,Lockshin MD,Atsumi T, et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS) [J]. J Thromb Haemost, 2006, 4(2): 295-306.
[3]	De Groot PG,De Laat B. Mechanisms of thrombosis in systemic lupus erythematosus and antiphospholipid syndrome [J]. Best Pract Res Clin Rheumatol, 2017, 31(3): 334-341.
[4]	Bienaimé F,Legendre C,Terzi F, et al. Antiphospholipid syndrome and kidney disease [J]. Kidney Int, 2017, 91(1): 34-44.
[5]	Pengo V,Bison E,Zoppellaro G, et al. APS - Diagnostics and challenges for the future [J]. Autoimmun Rev, 2016, 15(11): 1031-1033.
[6]	Schreiber K,Sciascia S,de Groot PG, et al. Antiphospholipid syndrome [J]. Nat Rev Dis Primers, 2018, 4: 17103.
[7]	Sciascia S,Cuadrado MJ,Khamashta M, et al. Renal involvement in antiphospholipid syndrome [J]. Nat Rev Nephrol, 2014, 10(5): 279-289.
[8]	Tektonidou MG,Sotsiou F,Nakopoulou L, et al. Antiphospholipid syndrome nephropathy in patients with systemic lupus erythematosus and antiphospholipid antibodies: prevalence, clinical associations, and long-term outcome [J]. Arthritis Rheum, 2004, 50(8): 2569-2579.
[9]	Mehrani T,Petri M. IgM anti-β2 glycoprotein I is protective against lupus nephritis and renal damage in systemic lupus erythematosus [J]. J Rheumatol, 2011, 38(3): 450-453.
[10]	Moroni G,Ventura D,Riva P, et al. Antiphospholipid antibodies are associated with an increased risk for chronic renal insufficiency in patients with lupus nephritis [J]. Am J Kidney Dis, 2004, 43(1): 28-36.
[11]	Tsuruta Y,Uchida K,Itabashi M, et al. Antiphospholipid antibodies and renal outcomes in patients with lupus nephritis [J]. Intern Med, 2009, 48(21): 1875-1880.
[12]	Jordan N,Chaib A,Sangle S, et al. Association of thrombotic microangiopathy and intimal hyperplasia with bleeding post-renal biopsy in antiphospholipid antibody-positive patients [J]. Arthritis Care Res (Hoboken), 2014, 66(5): 725-731.
[13]	Bhandari S,Harnden P,Brownjohn AM, et al. Association of anticardiolipin antibodies with intraglomerular thrombi and renal dysfunction in lupus nephritis [J]. QJM, 1998, 91(6): 401-409.
[14]	Pattanashetti N,Anakutti H,Ramachandran R, et al. Effect of thrombotic microangiopathy on clinical outcomes in Indian patients with lupus nephritis [J]. Kidney Int Rep, 2017, 2(5): 844-849.
[15]	Hahn BH,McMahon MA,Wilkinson A, et al. American College of Rheumatology guidelines for screening, treatment, and management of lupus nephritis [J]. Arthritis Care Res (Hoboken), 2012, 64(6): 797-808.
[16]	Bertsias GK,Tektonidou M,Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis [J]. Ann Rheum Dis, 2012, 71(11): 1771-1782.
[17]	Soyuöz A,Karadag Ö，Karaagaç T, et al. Therapeutic plasma exchange for refractory SLE: a comparison of outcomes between different sub-phenotypes [J]. Eur J Rheumatol, 2018, 5(1): 32-36.
[18]	Crowther MA,Ginsberg JS,Julian J, et al. A comparison of two intensities of warfarin for the prevention of recurrent thrombosis in patients with the antiphospholipid antibody syndrome [J]. N Engl J Med, 2003, 349(12): 1133-1138.
[19]	Cohen H,Hunt BJ,Efthymiou M, et al. Rivaroxaban versus warfarin to treat patients with thrombotic antiphospholipid syndrome, with or without systemic lupus erythematosus (RAPS): a randomised, controlled, open-label, phase 2/3, non-inferiority trial [J]. Lancet Haematol, 2016, 3(9): e426-e436.
[20]	Yagi S,Nishiyama S,Abe T, et al. Recurrent venous thromboembolism after discontinuation of rivaroxaban therapy in a patient with antiphospholipid syndrome [J]. BMJ Case Rep, 2019, 12(1): bcr-2018-227663.
[21]	Islam MA,Alam F,Wong KK，et al. Thrombotic management of antiphospholipid syndrome: towards novel targeted therapies [J]. Curr Vasc Pharmacol, 2017, 15(4): 313-326.
[22]	Ohnishi N,Fujieda Y,Hisada R，et al. Efficacy of dual antiplatelet therapy for preventing recurrence of arterial thrombosis in patients with antiphospholipid syndrome [J]. Rheumatology (Oxford), 2018，[Epub ahead of print]．
[23]	Wang CR,Liu MF. Rituximab usage in systemic lupus erythematosus-associated antiphospholipid syndrome: a single-center experience [J]. Semin Arthritis Rheum, 2016, 46(1): 102-108.
[24]	Kello N,Khoury LE,Marder G, et al. Secondary thrombotic microangiopathy in systemic lupus erythematosus and antiphospholipid syndrome, the role of complement and use of eculizumab: case series and review of literature [J]. Semin Arthritis Rheum, 2018, [Epub ahead of print]．
[25]	Unlu O,Erkan D. Catastrophic antiphospholipid syndrome: Candidate therapies for a potentially lethal disease [J]. Annu Rev Med, 2017, 68: 287-296.
[26]	Leone A,Radin M,Almarzooqi AM, et al. Autologous hematopoietic stem cell transplantation in systemic lupus erythematosus and antiphospholipid syndrome: a systematic review [J]. Autoimmun Rev, 2017, 16(5): 469-477.
[27]	刘维，张迪，吴沅皞. 系统性红斑狼疮的中医证候与用药文献分析[J]．国际中医中药杂志，2015，37(8)：731-734.
[28]	陈严文. 叶任高教授中西医结合治疗狼疮性肾炎的经验[J]. 中国中西医结合肾病杂志，2003，4(2)：65-66.
[29]	刘玉宁，邓跃毅，王立红. 陈以平教授治疗狼疮性肾炎的经验[J]. 中国中西医结合肾病杂志，2003，8(4)：437-438.
[30]	吴佳丽，鲍晓辉，周智林，等．益气活血化瘀法对系统性红斑狼疮血瘀证患者的疗效观察[J]．中国中西医结合肾病杂志，2003，23(11)860-861.
[31]	王首帆，戴蜀平，徐爱琴，等. 丹参联合激素对狼疮性肾炎患者血清IL-6的影响[J]. 中国实用医药，2013，8(2)：3-4.
[32]	Lin Y,Yan Y,Zhang H, et al. Salvianolic acid A alleviates renal injury in systemic lupus erythematosus induced by pristane in BALB/c mice[J]. Acta Pharm Sin B, 2017, 7(2)：159-166.
[33]	关明媚，傅君舟，郭群英，等．黄芪与丹参注射液联合治疗狼疮肾炎的临床观察[J]．中国中西医结合杂志，2003，9(4)：529-531.

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