Successful Management of Severe Hyperhaemolysis with Combined Tocilizumab and Rituximab in Non-Transfusion-Dependent Thalassaemia: A Case Report.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2023-02-01 DOI:10.1159/000524743

Amal M El Afifi, Alia M Saeed, Gihad H Fekry, Mariam A Mostafa, Reham A Elmetwally, Inas M Hamed, Aliaa N Hussein, Gomaa M Hasanien

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引用次数: 1

Abstract

Introduction: This is the fourth case reporting the administration of tocilizumab to control hyperhaemolysis. It was administered with rituximab to stop hyperhaemolysis refractory to frontline therapy. Hyperhaemolysis is a rare life-threatening subtype of delayed haemolytic transfusion reaction. Refractory cases pose a clinical challenge with no standard of care to date.

Case presentation: A 29-year-old lady with non-transfusion-dependent thalassaemia presented with refractory hyperhaemolysis necessitating the administration of rituximab. This was complicated with anaemic heart failure and altered sensorium exacerbated with further transfusions. A nadir haemoglobin of 2.1 g/dL was reached after the initiation of rituximab, and her condition was too critical to wait for the slow expected improvement. Hence, tocilizumab was given as a bridging therapy to block haemolysis till the delayed onset of radical treatment.

Conclusion: Tocilizumab can be effectively combined with rituximab to stop hyperhaemolytic episode refractory to first-line treatment when a prompt response is needed.

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托珠单抗联合利妥昔单抗成功治疗非输血依赖型地中海贫血的严重高溶血:1例报告。

这是第四个报告使用托珠单抗控制高溶血的病例。该药与利妥昔单抗联合使用，以阻止一线治疗难治性高溶血。高溶血是一种罕见的危及生命的亚型延迟溶血输血反应。难治性病例构成临床挑战，迄今尚无标准护理。病例介绍:一名29岁的非输血依赖型地中海贫血女性，出现难治性高溶血，需要给予利妥昔单抗。这并发贫血性心力衰竭和感觉改变，随着进一步输血而加剧。开始使用利妥昔单抗后，血红蛋白降至最低点2.1 g/dL，她的病情过于危急，无法等待预期的缓慢改善。因此，托珠单抗被用作桥接疗法来阻断溶血，直到延迟根治性治疗的开始。结论:Tocilizumab可有效联合利妥昔单抗治疗一线难治性高溶血发作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.