Persistent XXXX after induction of remission in @entity2883 : a therapeutic dilemma.

@entity1 @entity644 @entity8 @entity262 @entity786 @entity2883 @entity1011 @entity811 @entity631 @entity288
@entity2883 ( @entity2883 ) is a @entity262 that is often associated with an immune-mediated form of @entity631 ( @entity631 ). @entity8 most often manifests as microscopic @entity811 with or without red blood cell or mixed cellular casts, @entity644 , and an elevated serum @entity1011 concentration.We conducted the current study to determine whether persistent @entity811 , in the setting of apparent clinical remission, may reflect @entity8 and not active @entity8 . We performed a retrospective analysis of data from 82 @entity1 with new-onset @entity2883 , of whom 25 had @entity631 at presentation.Twenty of 25 @entity1 with @entity631 achieved sustained remissions (>6 consecutive months' duration). During initial periods of active disease the median peak serum @entity1011 was 1.9 mg/dL (range, 0.6-13.6 mg/dL). The median time to remission was 4 months (range, 2-13 mo). After effective therapy, median @entity1011 was 1.1 mg/dL (range, 0.4-1.8 mg/dL). Ten of 20 @entity1 had prolonged @entity811 over a period of >6 months. Within this subset, 5 subsequently normalized urine over a median period of 11 months and 5 did not achieve normal urine sediment over a median follow-up of 38 months. Thus, 10 of 25 @entity1 with @entity2883 and @entity631 had sustained @entity811 in spite of apparent prolonged clinical remission. @entity1 with @entity2883 and @entity631 may achieve enduring remissions that allow withdrawal of medications in spite of continued microscopic @entity811 with or without red blood cell casts that may persist for months or even years. Continued use of aggressive immunosuppressive therapies in such @entity1 would be ill-advised and could lead to irreversible and even life-threatening side effects from @entity786 or high-dose @entity288 .
