scholarly journals Late Worsening of COVID-19 Pneumonia: Successful Treatment with Ruxolitinib and Steroid

Author(s):  
Mauro Betelli ◽  
Fabio De Stefano ◽  
Alberto Tedeschi

We describe the case of a patient hospitalized for the second time in a month due to delayed worsening of lung lesions in COVID-19 infection without bacterial superinfection. He was treated with hydroxychloroquine, IV dexamethasone and ruxolitinib with rapid improvement of respiratory failure; 1 month after the second discharge, maintaining low-dose oral prednisone, lung consolidations were significantly reduced on control CT.

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Carol Chiung-Hui Peng ◽  
Rachel Huai-En Chang ◽  
Majorie Pennant ◽  
Huei-Kai Huang ◽  
Kashif M Munir

Abstract Painful Hashimoto thyroiditis (pHT) is a rare diagnosis, and optimal treatment remains unclear. To better characterize pHT, PubMed, Embase, Scopus, and Web of Science indexes were searched for case reports or case series reporting pHT, published between 1951 and February 2019. Seventy cases reported in 24 publications were identified. Female predominance (91.4%) and a median age of 39.00 years (interquartile range, 32.50-49.75 years) were observed. Among reported cases, 50.8% had known thyroid disease (including Hashimoto thyroiditis, Graves disease, and seronegative goiters), 83.3% had positive antithyroid peroxidase antibodies, and 71.2% had antithyroglobulin antibodies. Most cases did not have preceding upper respiratory tract symptoms or leukocytosis. Ultrasound features were consistent with Hashimoto thyroiditis. Thyroid function at initial presentation was hypothyroid (35.9%), euthyroid (28.1%), or thyrotoxic (35.9%). Cases evolved into hypothyroidism (55.3%) and euthyroidism (44.7%), whereas none became hyperthyroid after medical treatment. Thyroid size usually decreased after medical treatment. Most cases were empirically treated as subacute thyroiditis with corticosteroids, levothyroxine, or nonsteroidal anti-inflammatory drugs. However, no therapy provided sustained pain resolution. In subgroup analysis, low-dose oral prednisone (<25 mg/d) and intrathyroidal corticosteroid injection showed more favorable outcomes. Total thyroidectomy yielded 100% sustained pain resolution. Diagnosis of pHT is based on clinical evidence of Hashimoto thyroiditis and recurrent thyroid pain after medical treatment. The reference standard of diagnosis is pathology. Total thyroidectomy or intrathyroidal glucocorticoid injection should be considered if low-dose oral prednisone fails to achieve pain control.


1995 ◽  
Vol 22 (7) ◽  
pp. 512-514 ◽  
Author(s):  
Toshiyuki Yamamoto ◽  
Kyouko Kimura ◽  
Ichiro Katayama ◽  
Kiyoshi Nishioka

2013 ◽  
Vol 149 (8) ◽  
pp. 992 ◽  
Author(s):  
Xiaodong Li ◽  
Yuxiao Hong ◽  
Qian An ◽  
John Chen ◽  
Huachen Wei ◽  
...  

2016 ◽  
Vol 7 (1) ◽  
pp. ar.2016.7.0142 ◽  
Author(s):  
Patrick Kennedy ◽  
Ahmed Bassiouni ◽  
Alkis Psaltis ◽  
Jastin Antisdel ◽  
Joseph Brunworth

Objective In this report, we present a rare case of avascular necrosis (AVN) in an otherwise healthy 42-year-old male patient treated with low dose oral corticosteroids for his bronchitis. A systematic review of the literature related to AVN and corticosteroids was performed. Case Report Forty-two-year-old male with no underlying conditions predisposing him to AVN who had been treated four years before for chronic bronchitis with two courses of oral prednisone therapy presented with bilateral AVN of the hips. Methods An OVID database search of the terms “low total dose,” “corticosteroids,” and “avascular necrosis” was performed. Two PubMed searches of various permutations of “low-dose,” “corticosteroids,” “avascular necrosis,” and “osteonecrosis” were also performed. Results were then narrowed to relevant articles. Results Median total dose of oral corticosteroids in patients with AVN in reviewed articles was 981 mg, with lowest reported association at 105 mg. Median duration of therapy was 16 days with shortest course of six days. Conclusion There is emerging data linking AVN with corticosteroid doses previously thought to be safe. After reviewing the relevant literature, it is our consensus to inform all patients regarding AVN before oral corticosteroid use.


2005 ◽  
Vol 9 (3) ◽  
pp. 99-104 ◽  
Author(s):  
Candace Majeski ◽  
Muba Taher ◽  
Parbeer Grewal ◽  
Marlene Dytoc ◽  
Gilles Lauzon

Background: Scleromyxedema is a clinical variant of the rare disease papular mucinosis that has both cutaneous and systemic manifestations. Treatment options are numerous and tend to be associated with serious potential side effects and frequent relapse. Objective: We report a case of scleromyxedema treated with low-dose oral prednisone and intravenous immunoglobulin (IVIg). This is followed by a review of the literature. Conclusion: IVIg is being used for a growing number of inflammatory and immune disorders. It is being increasingly reported as a successful treatment for scleromyxedema. Although our patient succumbed to the disease, combination therapy with prednisone and IVIg provided temporary symptomatic, laboratory, and clinical improvement of the condition. Optimization of this therapeutic strategy is thus indicated for the management of scleromyxedema.


BMJ ◽  
1985 ◽  
Vol 291 (6505) ◽  
pp. 1305-1308 ◽  
Author(s):  
E Imbasciati ◽  
R Gusmano ◽  
A Edefonti ◽  
P Zucchelli ◽  
C Pozzi ◽  
...  

2009 ◽  
Vol 36 (4) ◽  
pp. 237-240 ◽  
Author(s):  
Masahiro OKA ◽  
Tsuneyoshi KAMO ◽  
Noriko GOTO ◽  
Tohru NAGANO ◽  
Yuji HIRAYAMA ◽  
...  

1987 ◽  
Vol 116 (3) ◽  
pp. 407-415 ◽  
Author(s):  
A.M. DEL C. BATLLE ◽  
ANA MARIA STELLA ◽  
ANA R. DE KAMINSKY ◽  
C. KAMINSKY ◽  
H.G. MARIANO

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