Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case
Background. The management of children with systemic lupus erythematosus (SLE) is usually associated with lifelong systemic glucocorticoids administration and, thereby, high risk of serious side effects, including steroid-induced diabetes. The belimumab (B-lymphocyte stimulator inhibitor) administra...
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"Paediatrician" Publishers LLC
2023-12-01
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| Series: | Вопросы современной педиатрии |
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| Online Access: | https://vsp.spr-journal.ru/jour/article/view/3356 |
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| author | Maria I. Kaleda Irina P. Nikishina Alesya V. Firsa |
| author_facet | Maria I. Kaleda Irina P. Nikishina Alesya V. Firsa |
| author_sort | Maria I. Kaleda |
| collection | DOAJ |
| description | Background. The management of children with systemic lupus erythematosus (SLE) is usually associated with lifelong systemic glucocorticoids administration and, thereby, high risk of serious side effects, including steroid-induced diabetes. The belimumab (B-lymphocyte stimulator inhibitor) administration significantly reduces the glucocorticoids dose, the risk and severity of steroid therapy complications. Clinical case description. The patient was diagnosed with SLE at the age of 16 years. Therapy with hydroxychloroquine and oral glucocorticoid at a high dose (methylprednisolone 56 mg per day) was initiated. Steroid-induced diabetes was diagnosed 1 month after the therapy start; avascular necrosis sites were revealed in 2 months. Mycophenolate mofetil made it possible to achieve the disease activity control. However, the belimumab was prescribed 5 months after diagnosis verification due to continuous insulin requirement and avascular necrosis progression. Conclusion. Belimumab is the only genetically engineered biologic drug approved for the treatment of children with SLE. As a result of its use, it was possible to stabilize the patient's condition quickly (within 3 months), to reduce significantly the dose of oral glucocorticoid, methylprednisolone (from 24 to 8 mg/day), to achieve remission of steroidinduced diabetes with further insulin withdrawal, and also to relieve avascular necrosis clinical symptoms. |
| format | Article |
| id | doaj-art-5c61d49f84d14f00899f76260e1ad7cd |
| institution | DOAJ |
| issn | 1682-5527 1682-5535 |
| language | English |
| publishDate | 2023-12-01 |
| publisher | "Paediatrician" Publishers LLC |
| record_format | Article |
| series | Вопросы современной педиатрии |
| spelling | doaj-art-5c61d49f84d14f00899f76260e1ad7cd2025-08-20T03:01:15Zeng"Paediatrician" Publishers LLCВопросы современной педиатрии1682-55271682-55352023-12-0122654655310.15690/vsp.v22i6.26492151Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical CaseMaria I. Kaleda0Irina P. Nikishina1Alesya V. Firsa2Research Institute of Rheumatology named after V.A. NasonovaResearch Institute of Rheumatology named after V.A. NasonovaResearch Institute of Rheumatology named after V.A. NasonovaBackground. The management of children with systemic lupus erythematosus (SLE) is usually associated with lifelong systemic glucocorticoids administration and, thereby, high risk of serious side effects, including steroid-induced diabetes. The belimumab (B-lymphocyte stimulator inhibitor) administration significantly reduces the glucocorticoids dose, the risk and severity of steroid therapy complications. Clinical case description. The patient was diagnosed with SLE at the age of 16 years. Therapy with hydroxychloroquine and oral glucocorticoid at a high dose (methylprednisolone 56 mg per day) was initiated. Steroid-induced diabetes was diagnosed 1 month after the therapy start; avascular necrosis sites were revealed in 2 months. Mycophenolate mofetil made it possible to achieve the disease activity control. However, the belimumab was prescribed 5 months after diagnosis verification due to continuous insulin requirement and avascular necrosis progression. Conclusion. Belimumab is the only genetically engineered biologic drug approved for the treatment of children with SLE. As a result of its use, it was possible to stabilize the patient's condition quickly (within 3 months), to reduce significantly the dose of oral glucocorticoid, methylprednisolone (from 24 to 8 mg/day), to achieve remission of steroidinduced diabetes with further insulin withdrawal, and also to relieve avascular necrosis clinical symptoms.https://vsp.spr-journal.ru/jour/article/view/3356systemic lupus erythematosus with juvenile onsetoral glucocorticoidssteroid-induced diabetesavascular necrosisbelimumab |
| spellingShingle | Maria I. Kaleda Irina P. Nikishina Alesya V. Firsa Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case Вопросы современной педиатрии systemic lupus erythematosus with juvenile onset oral glucocorticoids steroid-induced diabetes avascular necrosis belimumab |
| title | Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case |
| title_full | Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case |
| title_fullStr | Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case |
| title_full_unstemmed | Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case |
| title_short | Belimumab in a Patient with Systemic Lupus Erythematosus with Juvenile Onset and Steroid-induced Diabetes: Clinical Case |
| title_sort | belimumab in a patient with systemic lupus erythematosus with juvenile onset and steroid induced diabetes clinical case |
| topic | systemic lupus erythematosus with juvenile onset oral glucocorticoids steroid-induced diabetes avascular necrosis belimumab |
| url | https://vsp.spr-journal.ru/jour/article/view/3356 |
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