‘A finger in the wound’, is an expression by Condon et al1 used in their very interesting paper treating severe lupus nephritis with rituximab and mycophenolate, additionally to intravenous methyl-prednisolone, but not long-term oral steroids, achieving a good clinical response in most patients.

Rheumatologists and nephrologists have the notion that glucocorticoids are the cornerstone for the treatment of autoimmune diseases, particularly lupus nephritis, where steroids …