A 28-year-old woman with class IV lupus nephritis achieves remission after induction therapy with intravenous cyclophosphamide and corticosteroids. What is the recommended maintenance immunosuppressive regimen?
- A Mycophenolate mofetil ✓
- B Continue monthly intravenous cyclophosphamide
- C Rituximab every 6 months
- D Cyclosporine
Correct answer: A. Mycophenolate mofetil
Explanation
After induction, maintenance therapy for lupus nephritis is mycophenolate mofetil or azathioprine, as per current guidelines. Continued cyclophosphamide is avoided due to cumulative toxicity. Rituximab is reserved for refractory cases. Cyclosporine is not standard maintenance. Mycophenolate has comparable efficacy with better safety.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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