Die Herausforderung der Lupusnephritis

ZUSAMMENFASSUNG

Die Lupusnephritis (LN) ist eine schwerwiegende Manifestation des systemischen Lupus erythematodes (SLE) und betrifft 20–60 % der SLE-Patienten. Ihre Pathophysiologie ist komplex; sie umfasst das humorale Immunsystem, zelluläre Immunmechanismen, das Komplementsystem sowie genetische Faktoren. Ein regelmäßiges Screening von SLE-Patienten auf LN ist entscheidend und sollte serologische Untersuchungen sowie eine Urinanalyse beinhalten. Bei Verdacht auf LN ist eine Nierenbiopsie indiziert, wobei das Fullhouse-Ablagerungsmuster (IgG, IgA, IgM, C1q, C3) ein charakteristisches Merkmal ist. Die Therapie der LN entwickelt sich stetig weiter und neue Therapieansätze werden erforscht. Zur Induktionstherapie gehören Glukokortikoide, Hydroxychloroquin und mindestens ein weiteres Immunsuppressivum. Nach dem Erreichen eines Therapieansprechens folgt eine Erhaltungstherapie, für die Mycophenolatmofetil (MMF) oder Mycophenolsäure (MPA) als erste Wahl gelten.

Publication History

Article published online:
24 July 2024

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