Esther L Albuquerque, Damaris Jacota, Megan Vu, Sarah E Kubes
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引用次数: 0
Abstract
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune central nervous system disease with inflammatory events recurring in the optic nerves and spinal cord. Neuromyelitis optica (NMO) is rare in children, and pediatric patients typically present with optic neuritis following infections. Lack of response to pulse-dose intravenous corticosteroids or recurrent relapse episodes warrant therapies such as plasma exchange, intravenous immunoglobulin (IVIG), and rituximab. In adult studies, tocilizumab has been used and found to reduce NMO relapse; however, limitations exist in the pediatric population due to the lack of studies and formal treatment guidelines. Gastrointestinal perforation (GIP) is a rare, life-threatening complication identified in clinical trials during tocilizumab therapy. We report a case of a fatal, infected GIP following a single dose of tocilizumab for refractory NMO in a 15-year-old male. This case highlights the need for more outcomes data when using tocilizumab to treat pediatric NMO. Additionally, an assessment of patient-specific risk factors should be outlined to better direct safe therapy and to minimize negative adverse outcomes.
期刊介绍:
The Journal of Pediatric Pharmacology and Therapeutics is the official journal of the Pediatric Pharmacy Advocacy Group. JPPT is a peer-reviewed multi disciplinary journal that is devoted to promoting the safe and effective use of medications in infants and children. To this end, the journal publishes practical information for all practitioners who provide care to pediatric patients. Each issue includes review articles, original clinical investigations, case reports, editorials, and other information relevant to pediatric medication therapy. The Journal focuses all work on issues related to the practice of pediatric pharmacology and therapeutics. The scope of content includes pharmacotherapy, extemporaneous compounding, dosing, methods of medication administration, medication error prevention, and legislative issues. The Journal will contain original research, review articles, short subjects, case reports, clinical investigations, editorials, and news from such organizations as the Pediatric Pharmacy Advocacy Group, the FDA, the American Academy of Pediatrics, the American Society of Health-System Pharmacists, and so on.