Dorota Suszek

Publications of Dorota Suszek

• [Mycophenolate mofetil for the treatment of lupus nephritis. The case of lupus nephritis--class IV according to WHO--treated with mycophenolate mofetil].

  Authors: Dorota Suszek, Ewa Wielosz, Maria Majdan

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:91-4.

  Lupus nephritis (LN) develops in almost 60% of patients with systemic lupus erythematosus. In its most severe proliferative forms, LN often leads to end-stage renal failure. Therapeutic regimens inLupus nephritis (LN) develops in almost 60% of patients with systemic lupus erythematosus. In its most severe proliferative forms, LN often leads to end-stage renal failure. Therapeutic regimens in severe lupus nephropathies, especially class IV according to WHO, are based on glucocorticosteroids (GCSs) administered together with cyclophosphamide (CPA) as the first-line drugs. New therapeutic options appeared once immunosuppressive properties of mycophenolic acid derivatives (mycophenolate mofetil) were documented. We describe a patient with LN class IV treated according to various immunosuppressive protocols adjusted to the degree of LN activity. The remission-inducing protocol based on intravenous pulses of GCSs and CPA resulted in regression of renal lesions but was associated with the risk of complications. Mycophenolate mofetil was found effective for maintenance therapy. The choice of therapy for patients with LN should be based on the severity of renal disease at the time of diagnosis and on the histopathology of the renal bioptate. Discrepancies obtain as to first-line drugs for severe forms of LN and duration of remission-inducing therapy.

• Nephrotic syndrome as a clinical manifestation of systemic sclerosis.

  Authors: Ewa Wielosz, Maria Majdan, Dorota Suszek, Iwona Smarz-Widelska, Agnieszka Korolczuk, Elzbieta Korobowicz

  Rheumatology international. 10/2007; 27(11):1087-9.

  We have described the unusual case of coexistence of membranous nephropathy resulting in nephrotic syndrome with systemic sclerosis. A 60-year-old patient was admitted to the Department of NephrologyWe have described the unusual case of coexistence of membranous nephropathy resulting in nephrotic syndrome with systemic sclerosis. A 60-year-old patient was admitted to the Department of Nephrology with marked proteinuria and oedema. The renal biopsy specimen disclosed the features characteristic of membranous glomerulonephritis. The patient was treated with chlorambucil for 1 month followed by prednisone for 1 month. However, her condition still did not improve. Therefore, the other causes of nephrotic syndrome were investigated. Once anti-Scl-70 antibody was detected the patient was transferred to the Department of Rheumatology and Connective Tissue Diseases. Physical examination revealed Raynaud phenomenon, sclerodactylia, thickened skin of the chest and back. The patient was diagnosed with diffuse systemic sclerosis. The cyclophosphamide therapy was instituted and the patient's condition improved.

• [Overlap syndrome autoimmune hepatitis and primary biliary cirrhosis associated with antiphospholipid syndrome]

  Authors: Bozena Targońska-Stepniak, Maria Majdan, Dorota Suszek, Katarzyna Laskowska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2006; 21(125):480-3.

  The paper presents diagnostic problems and therapeutic management in a case of 34 year old woman with antiphospholipid syndrome (APS) connected with overlap syndrome: autoimmune hepatitis (AIH) andThe paper presents diagnostic problems and therapeutic management in a case of 34 year old woman with antiphospholipid syndrome (APS) connected with overlap syndrome: autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). Life threatening cardiac arrhythmia was the first clinical manifestation of the disease. Pulmonary embolism occurred a few months later, with the presence of antiphospholipid antibodies. The diagnosis of AlH and PBC was made as a result of further research of complex immunological disturbances observed in the patient and after liver biopsy.

• [Relations beetwen severity of anemia and certain antiphospholipid antibodies presence in systemic lupus erythematosus patients]

  Authors: Dorota Suszek, Maria Majdan, Dariusz Chudzik, Magdalena Dryglewska

  Polskie archiwum medycyny wewnȩtrznej. 06/2006; 115(5):426-31.

  Anaemia is a common hematological abnormality in systemic lupus erythematosus (SLE). Autoimmune hemolytic anaemia (AHA) is one of the types of anaemia in SLE. Other reasons of anaemia in SLE are:Anaemia is a common hematological abnormality in systemic lupus erythematosus (SLE). Autoimmune hemolytic anaemia (AHA) is one of the types of anaemia in SLE. Other reasons of anaemia in SLE are: chronic inflammatory diseases, insufficient level of elements necessary for erythropoiesis and chronic renal disease. The aim of the study was to examine the relations between severity of anemia and presence of certain antiphospholipid antibodies (aPL) in SLE. The study group consisted of 24 patients (one man and 23 women) with active lupus. Anticardiolipin antibodies (aCL), anti-02 glycoprotein I antibodies (anti-beta2 GPI IgM and IgG) and red cell parameters: haemoglobin level (Hb), erythrocytes (RBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin mass (MCH), mean corpuscular haemoglobin concentration (MCHC) and ferritin level were measured before beginning or intensification of treatment. The activity of SLE was measured by SLEDAI and C3 complements. The patients were divided into two subgroups: subgroup with aCL-IgG above 20 u/ml and below 20 u/ml. In patients with aCL-IgG above 20 u/ml the mean Hb level was lower, and the mean ferritin level was significantly higher than in patients with aCL-IgG level below 20 u/ml. We observed a negative, significant correlations between Hb and aCL-IgG (p = 0.01; R = -0.47) and between Hb and anti-32 GPI IgG (p = 0,0003; R = -0,67) and a negative correlation between Hb and activity of SLE estimated by SLEDAI (p = 0.02; R = -0.45) and positive between Hb and C3 complement (p = 0.02; R = +0.5). In conclusion: antiphospholipid antibodies presence in patients with SLE can influence the severity of anaemia.