| 초록 |
Case Study: Lupus nephritis (LN) is a major organ manifestation of systemic lupus erythematosus and is associated with significant morbidity. Voclosporin, a novel calcineurin inhibitor is recommended as a treatment for LN. However, real-world data using the AURORA protocol remains limited. We report the case of 18-year-old woman diagnosed with LN (ISN V). At age 12, she developed nephrotic syndrome and was diagnosed with idiopathic membranous nephropathy by renal biopsy. She achieved complete remission following corticosteroid therapy. Subsequently, anti-double-stranded DNA antibodies and hypocomplementemia appeared; however, as she did not meet the SLICC classification criteria, she was followed with renin-angiotensin system inhibitor therapy. One year later, increased proteinuria was observed, and she was diagnosed with systemic lupus erythematosus based on the SLICC classification criteria and repeat renal biopsy revealed LN (ISN V). As in the AURORA trial, a treatment regimen combining voclosporin with corticosteroids, hydroxychloroquine, and mycophenolate mofetil was initiated for the purpose of reducing corticosteroid dosage. Complete remission was achieved 18 days after treatment initiation. Corticosteroids were successfully discontinued at 25 weeks, and complete remission has been maintained without relapse. No serious adverse events were observed. This case presents the first real-world data that voclosporin-based therapy following the AURORA regimen achieves rapid complete remission and enables early corticosteroid withdrawal of corticosteroid. |