The mycophenolate mofetil (MMF) is an immunosuppressive drug used in the treatment of autoimmune diseases including juvenile systemic lupus erythematosus, especially in cases of lupus nephritis refractory to treatment with corticosteroids, cyclophosphamide, azathioprine, methotrexate and/or cyclosporine. This paper describes the efficacy and adverse events of MMF in four patients with refractory lupus nephritis. The patients were followed up for 2,1 to 11,1 years (mean 6,8 years) and treated with a MMF dose of 1 to 3g/day for a period of 3 to 36 months (mean 13,75 months). Two patients (one with renal histologic class IV and another with class V) presented an improvement with a decrease in the 24h proteinúria. The best efficacy was observed in the patient with class V, as described in literature. Two patients did not respond (one class III and other class IV) and they presented acute renal failure, one of them continued with nephrotic proteinúria. Adverse events were not observed. MMF can be an alternative therapy for juvenile patients with refractory lupus nephritis, especially in cases of renal histologic classes V and IV.
systemic lupus erythematosus; nephritis; mycophenolate mofetil; children and adolescents
