Sudden onset blindness treated with pulse steroid therapy in a patient with microscopic polyangiitis

AbstractWe report a 71-year-old male with microscopic polyangiitis (MPA) who developed sudden-onset, progressive, bilateral visual loss associated with a relapse of MPA symptoms. The patient was referred to our hospital, and treated with intravenous pulse steroid therapy and high-dose oral prednisolone. Although the right eye remained vision deficient, visual acuity in the left eye recovered. Ocular manifestations of MPA are quite uncommon. This case emphasizes the necessity of early detection and initiation of prompt therapy where ocular manifestations of MPA occur.

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Drug-induced acute interstitial nephritis: Prospective randomized trial comparing oral steroids and high-dose intravenous pulse steroid therapy in guiding the treatment of this condition

Saudi Journal of Kidney Diseases and Transplantation ◽

10.4103/1319-2442.235171 ◽

2018 ◽

Vol 29 (3) ◽

pp. 598 ◽

Cited By ~ 6

Author(s):

AbdulMajeed Chowdry ◽

Hilal Azad ◽

Intkhab Mir ◽

MohdSaleem Najar ◽

BhatMohd Ashraf ◽

...

Keyword(s):

Randomized Trial ◽

Interstitial Nephritis ◽

Steroid Therapy ◽

Acute Interstitial Nephritis ◽

Prospective Randomized Trial ◽

High Dose ◽

Drug Induced ◽

Pulse Steroid Therapy ◽

Oral Steroids ◽

Pulse Steroid

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Relapsing polychondritis presented as inner ear involvement

The Journal of Laryngology & Otology ◽

10.1017/s002221510013302x ◽

1996 ◽

Vol 110 (2) ◽

pp. 154-157 ◽

Cited By ~ 7

Author(s):

Yasuyuki Kimura ◽

Hiroko Miwa ◽

Mitsuru Furukawa ◽

Yuji Mizukami

Keyword(s):

Inner Ear ◽

Steroid Therapy ◽

Correct Diagnosis ◽

Herbal Medicines ◽

Relapsing Polychondritis ◽

Oral Prednisolone ◽

Sudden Onset ◽

Initial Symptom ◽

Old Japanese ◽

Dose Oral

AbstractWe report a rare case of relapsing polychondritis with an initial symptom of inner ear involvement. This 53-year-old Japanese man experienced a hearing difficulty, tinnitus in both ears, and dizziness of sudden onset, but lacked auricular chondritis at that time, which is the most frequent finding in relapsing polychondritis. Thus it was difficult to reach a correct diagnosis. Steroid therapy, with oral prednisolone 15 mg daily, was effective. Almost two months after we began the steroid therapy, the patient complained of losing interest in his work and reported a hallucination vision on the TV screen, so the dose of prednisolone was decreased to 10 mg. The hallucinations then disappeared, but the serum level of C-reactive protein increased highly. To reduce the dose of prednisolone, we tried low-dose oral methotrexate. However, we had to discontinue it when the patient experienced severe vomiting and diarrhoea. As adjuvant therapy, we then administered Sho-saiko-to, Chinese herbal medicines with few side effects. Symptoms and laboratory abnormalities then improved markedly.

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Pulse steroid therapy in rheumatoid arthritis: can equivalent doses of oral prednisolone give similar clinical results to intravenous methylprednisolone?

Annals of the Rheumatic Diseases ◽

10.1136/ard.47.1.28 ◽

1988 ◽

Vol 47 (1) ◽

pp. 28-33 ◽

Cited By ~ 24

Author(s):

M D Smith ◽

M J Ahern ◽

P J Roberts-Thomson

Keyword(s):

Rheumatoid Arthritis ◽

Steroid Therapy ◽

Oral Prednisolone ◽

Clinical Results ◽

Intravenous Methylprednisolone ◽

Pulse Steroid Therapy ◽

Pulse Steroid

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Successful Treatment of Plasma Cell-Rich Acute Rejection Using Pulse Steroid Therapy Alone: A Case Report

Case Reports in Transplantation ◽

10.1155/2017/1347052 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7

Author(s):

Yo Komatsuzaki ◽

Yasuyuki Nakada ◽

Izumi Yamamoto ◽

Mayuko Kawabe ◽

Takafumi Yamakawa ◽

...

Keyword(s):

Acute Rejection ◽

Plasma Cell ◽

Steroid Therapy ◽

Plasma Cells ◽

Immunosuppressive Agents ◽

High Dose ◽

Protocol Biopsy ◽

Pulse Steroid Therapy ◽

Allograft Biopsy ◽

Pulse Steroid

Despite the recent development of immunosuppressive agents, plasma cell-rich acute rejection (PCAR) has remained refractory to treatment. Herein, we report an unusual case of PCAR that responded well to pulse steroid therapy alone. A 47-year-old man was admitted for a protocol biopsy three months after kidney transplantation, with a stable serum creatinine level of 1.6 mg/dL. Histological examination showed focal aggressive tubulointerstitial inflammatory cell infiltration of predominantly polyclonal mature plasma cells, leading to our diagnosis of PCAR. Three months following three consecutive days of high-dose methylprednisolone (mPSL) therapy, an allograft biopsy performed for therapy evaluation showed persistent PCAR. We readministered mPSL therapy and successfully resolved the PCAR. Although PCAR generally develops more than six months after transplantation, we diagnosed this case early, at three months after transplantation, with focally infiltrated PCAR. This case demonstrates the importance of early diagnosis and prompt treatment of PCAR to manage the development and severity of allograft rejection.

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