scholarly journals Low-Dose Prednisone Treatment for IVIG-Resistant Kawasaki Disease with Severe Arthritis and Joint Effusion in Two 3-Year-Old Children

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Lingling Fan ◽  
Huimin Lv ◽  
Shujuan Jiang ◽  
Daogang Qin
Keyword(s):  
Kawasaki Disease ◽  
Joint Pain ◽  
Low Dose ◽  
Oral Prednisone ◽  
Joint Effusion ◽  
Severe Arthritis ◽  
Dose Oral ◽  
Magnetic Resonance Imaging Mri ◽  
Dose Prednisone ◽  
Ivig Administration

Kawasaki disease (KD) is a global disease in children. The etiology and pathogenesis are unknown. Complications vary among patients. Fever can persist in some after immune globulin (IVIG) administration, termed IVIG-resistant KD. Here, we report two cases of IVIG-resistant KD with severe arthritis. The diagnosis of arthritis was confirmed by magnetic resonance imaging (MRI) showing joint effusion. Remarkably, fever and joint pain had not receded after the second dose of IVIG. To further manage the symptoms, we prescribed low-dose oral prednisone with success. Both fever and joint pain were diminished. We ponder that the low-dose prednisone might be an option to treat IVIG-resistant KD with severe arthritis.

scholarly journals A Literature Review of Painful Hashimoto Thyroiditis: 70 Published Cases in the Past 70 Years

2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Carol Chiung-Hui Peng ◽  
Rachel Huai-En Chang ◽  
Majorie Pennant ◽  
Huei-Kai Huang ◽  
Kashif M Munir
Keyword(s):  
Medical Treatment ◽  
Total Thyroidectomy ◽  
Low Dose ◽  
Case Reports ◽  
Corticosteroid Injection ◽  
Oral Prednisone ◽  
Case Series ◽  
Hashimoto Thyroiditis ◽  
Upper Respiratory Tract ◽  
Dose Oral

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.

scholarly journals Avascular Necrosis after Oral Corticosteroids in Otolaryngology: Case Report and Review of the Literature

2016 ◽  
Vol 7 (1) ◽  
pp. ar.2016.7.0142 ◽  
Author(s):  
Patrick Kennedy ◽  
Ahmed Bassiouni ◽  
Alkis Psaltis ◽  
Jastin Antisdel ◽  
Joseph Brunworth
Keyword(s):  
Case Report ◽  
Total Dose ◽  
Avascular Necrosis ◽  
Low Dose ◽  
Relevant Literature ◽  
Oral Prednisone ◽  
Review Of The Literature ◽  
Median Total Dose ◽  
Oral Corticosteroids ◽  
Dose Oral

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.

scholarly journals Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Hao Zhang ◽  
Mei-ying Wang ◽  
Yong-nan Teng ◽  
Xiao-dan Wang ◽  
Hai-tao Cao
Keyword(s):  
Single Dose ◽  
Kawasaki Disease ◽  
Low Dose ◽  
Clinical Effect ◽  
Pulse Therapy ◽  
Inflammatory Factors ◽  
Control Group ◽  
High Dose ◽  
Experimental Group ◽  
Dose Prednisone

Objective: To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD). Methods: Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated. Results: After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04). Conclusion: HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced. doi: https://doi.org/10.12669/pjms.37.4.4023 How to cite this:Zhang H, Wang MY, Teng YN, Wang XD, Cao HT. Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4023 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Low-Dose Prednisone Decreases the Severity but Not the Frequency of Lenalidomide Associated Tumor Flare Feaction (TFR) in Chronic Lymphocytic Leukemia (CLL) Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4987-4987
Author(s):  
Laurie Musial ◽  
Kena C. Miller ◽  
Amy Tonelli ◽  
Rami Manochakian ◽  
Swaminathan Padmanabhan ◽  
...  
Keyword(s):  
Low Dose ◽  
Oral Prednisone ◽  
Single Agent ◽  
Lymphocytic Leukemia ◽  
Common Side Effect ◽  
Low Grade ◽  
Group A ◽  
Considerable Morbidity ◽  
Group B ◽  
Dose Prednisone

Abstract Introduction: Lenalidomide (L) is clinically active in pts with CLL. TFR is a common side effect of L, unique to CLL pts and is characterized by tender enlargement of lymph nodes (LN), spleen and/or liver with low-grade fever, rash and/or increase in white blood cell count. Onset is usually with 24 hours of first dose and it is rarely seen after the 1st cycle. The underlying etiology of TFR remains undetermined though clinical presentation is suggestive of an immune activation phenomenon. Diagnosis, management and effective prophylaxis of TFR is crucial for the pt care as it is associated with considerable morbidity and mimics disease progression. We investigated the effectiveness of low-dose prednisone prophylaxis in CLL pts treated with L. Method & Results: Forty five pts (36 male, 9 female), median age 64 years (range 42–75) with rel/ref CLL were enrolled on a phase II clinical trial. Single agent L (max. dose 25mg/day) was given to all pts enrolled. No prophylaxis was given to the first 29 pts (group A). Subsequently 16 pts (group B) were treated with prednisone 20mg PO QD × 5 days followed by 10mg PO QD × 5 days, starting day 1 of treatment. Median age was 64 years (range 42–75) with 36M and 9F. Stage III/IV disease was noted in 64% (n=18) of the pts. Twenty four (83%) pts in group A and 13 (81%) in group B developed TFR with &gt; grade II TFR was seen in 31% and 6%, respectively. Among pts with TFR, 4 achieved complete remission (CR) and had grade &gt; 2 reaction vs. 19 pts with a &lt; partial remission who had a median of grade 1 (range 1–2) TFR. Conclusion: Although the sample size investigated is small, we observed that use of oral prednisone prophylaxis decreased the severity but not the overall incidence of TFR. We therefore recommend that low-dose prednisone be considered for lenalidomide associated TFR in patients with CLL.

Combination Oral Prednisone and Intravenous Immunoglobulin in the Treatment of Scleromyxedema

2005 ◽  
Vol 9 (3) ◽  
pp. 99-104 ◽  
Author(s):  
Candace Majeski ◽  
Muba Taher ◽  
Parbeer Grewal ◽  
Marlene Dytoc ◽  
Gilles Lauzon
Keyword(s):  
Intravenous Immunoglobulin ◽  
Therapeutic Strategy ◽  
Low Dose ◽  
Treatment Options ◽  
Oral Prednisone ◽  
Immune Disorders ◽  
Review Of The Literature ◽  
Condition Optimization ◽  
Dose Oral ◽  
Systemic Manifestations

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.

scholarly journals Controlled trial of methylprednisolone pulses and low dose oral prednisone for the minimal change nephrotic syndrome.

BMJ ◽  
1985 ◽  
Vol 291 (6505) ◽  
pp. 1305-1308 ◽  
Author(s):  
E Imbasciati ◽  
R Gusmano ◽  
A Edefonti ◽  
P Zucchelli ◽  
C Pozzi ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Low Dose ◽  
Controlled Trial ◽  
Oral Prednisone ◽  
Minimal Change Nephrotic Syndrome ◽  
Minimal Change ◽  
Dose Oral

Use of Low-Dose Oral Prednisone to Prevent Paclitaxel-Induced Arthralgias and Myalgias

1999 ◽  
Vol 72 (1) ◽  
pp. 100-101 ◽  
Author(s):  
Maurie Markman ◽  
Alexander Kennedy ◽  
Kenneth Webster ◽  
Barbara Kulp ◽  
Gertrude Peterson ◽  
...  
Keyword(s):  
Low Dose ◽  
Oral Prednisone ◽  
Dose Oral

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

2020 ◽  
Author(s):  
Mauro Betelli ◽  
Fabio De Stefano ◽  
Alberto Tedeschi
Keyword(s):  
Respiratory Failure ◽  
Successful Treatment ◽  
Low Dose ◽  
Oral Prednisone ◽  
Rapid Improvement ◽  
Lung Lesions ◽  
Dose Oral ◽  
Bacterial Superinfection

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.

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