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PREFACE
1. The necessary of study
Systemic lupus erythematosus is the first autoimmune disease was described,
which characterized by heterogeneous, multisystem involvement and the production of
an array of autoantibodies. There is no gold standard test for the diagnosis of SLE. The
first classification criteria for SLE were developed by the Ameriacan Rheumatism
Association in 1971. The revised criteria for the classification of SLE were published in
1982 and last time in 1997. In 2012 the Systemic International Collaborating Clinics
group to further revise the ACR classification criteria. SLE can affect almost any organ
and display a broad spectrum of manifestations. Renal involvement in SLE remains
the strongest predictor of overall patient morbidity and mortality.The presence of
autoantibodies against a variety of ubiquitous self-antigens is a hallmark of systemic
lupus erythematosus. Mechanism of autoantibody production would require a thorough
inderstanding of the loss of self-tolerance in both T and B cells.
Management of lupus nephritis has always been of interest to studys around the
world and there have been numerous randomized clinical trials that classify and evaluate
the role of immunosuppressant drugs in the treatment of lupus nephritis.
Mycophenolate mofetil (MMF) is a new immunosuppressant, has the ability to
inhibit differentiation of both T and B Lymphocytes. There are numerous randomized
clinical trials assessing the role of MMF in the treatment of lupus nephritis. Recently
guideline for lupus nephrits worldwide as well as in Vietnam, have agreed to the
indication of MMF for the treatment of lupus nephritis.
In Vietnam currently no study to assess the effectiveness and immune
modification of MMF in treating lupus nephritis. Therefore, we conducted the
dissertation “Study on the immune modification and effectiveness of treatment in
patients with lupus nephritis after induction treatment with Mycophenolate mofetil” for
2 purposes:
1. Investigation of clinical changes, paraclinincal and some immune
modifications in patients with lupus nephritis after induction therapy was indicated
Mycophenolate mofetil.
2. Assess the effectiveness of Mycophenolate mofetil in induction therapy in
patients with lupus nephritis and the relationship with immune modifications.
2. Summary of new main scientific contribution of the dissertation
The first study to evaluate the effectiveness of treatment and immune
modification in adult patients with lupus nephritis, who were treated with
