My brother is 27 and has been diagnosed with Lupus Nephritis it is very aggressive and he has already been treated with chemo and currently on cytoxin however his kidneys are deteriorating and most dtrs & hospitals in my area do not know how to effectively treat him? We live in PA where would be the best place to bring him for expert help?

Aggressive forms of lupus nephritis are often treated with oral doses of prednisone and intravenous pulses of cyclophosphamide. Although the majority of patients respond all do not. In these circumstances studies from the NIH suggest combinations of intravenous pulses of steroid with cyclophosphamide is superior to either alone. An additional option, although still considered experimental, is treatment with rituximab. An excellent option in Pennsylvania is the Lupus Center of Excellence at the University of Pittsburgh School of Medicine and specifically, Dr. Susan Manzi.

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