About: Prolonged extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome in a child affected by rituximab-resistant autoimmune hemolytic anemia: a case report

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About: Prolonged extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome in a child affected by rituximab-resistant autoimmune hemolytic anemia: a case report Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Prolonged extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome in a child affected by rituximab-resistant autoimmune hemolytic anemia: a case report
Creator	Foti, Giuseppe Patroniti, Nicolo Beretta, Chiara Biagi, Ettore Jankovic, Momcilo Leoni, Veronica Rossi, Mario
Source	PMC
abstract	INTRODUCTION: Autoimmune hemolytic anemia in children younger than 2 years of age is usually characterized by a severe course, with a mortality rate of approximately 10%. The prolonged immunosuppression following specific treatment may be associated with a high risk of developing severe infections. Recently, the use of monoclonal antibodies (rituximab) has allowed sustained remissions to be obtained in the majority of pediatric patients with refractory autoimmune hemolytic anemia. CASE PRESENTATION: We describe the case of an 8-month-old Caucasian girl affected by a severe form of autoimmune hemolytic anemia, which required continuous steroid treatment for 16 months. Thereafter, she received 4 weekly doses of rituximab (375 mg/m(2)/dose) associated with steroid therapy, which was then tapered over the subsequent 2 weeks. One month after the last dose of rrituximab, she presented with recurrence of severe hemolysis and received two more doses of rrituximab. The patient remained in clinical remission for 7 months, before presenting with a further relapse. An alternative heavy immunosuppressive therapy was administered combining cyclophosphamide 10 mg/kg/day for 10 days with methylprednisolone 40 mg/kg/day for 5 days, which was then tapered down over 3 weeks. While still on steroid therapy, the patient developed an interstitial pneumonia with Acute Respiratory Distress Syndrome, which required immediate admission to the intensive care unit where extracorporeal membrane oxygenation therapy was administered continuously for 37 days. At 16-month follow-up, the patient is alive and in good clinical condition, with no organ dysfunction, free from any immunosuppressive treatment and with a normal Hb level. CONCLUSIONS: This case shows that aggressive combined immunosuppressive therapy may lead to a sustained complete remission in children with refractory autoimmune hemolytic anemia. However, the severe life-threatening complication presented by our patient indicates that strict clinical monitoring must be vigilantly performed, that antimicrobial prophylaxis should always be considered and that experienced medical and nursing staff must be available, to deliver highly specialized supportive salvage therapies, if necessary, during intensive care monitoring.
has issue date	2009-04-01(xsd:dateTime)
bibo:doi	10.1186/1752-1947-3-6443
bibo:pmid	19830103
has license	cc-by
sha1sum (hex)	73de1d6e4f75f6faed0be87bdb3994b18ce15d29
schema:url	https://doi.org/10.1186/1752-1947-3-6443
resource representing a document's title	Prolonged extracorporeal membrane oxygenation therapy for severe acute respiratory distress syndrome in a child affected by rituximab-resistant autoimmune hemolytic anemia: a case report
has PubMed Central identifier	PMC2726476
has PubMed identifier	19830103
schema:publication	J Med Case Reports
resource representing a document's body	covid:73de1d6e4f75f6faed0be87bdb3994b18ce15d29#body_text
is schema:about of	named entity 'pediatric' named entity 'monoclonal antibodies' named entity 'younger' named entity 'HIGH RISK OF' named entity 'YEARS' named entity 'PEDIATRIC' named entity 'MONOCLONAL ANTIBODIES' named entity 'DEVELOPING' named entity 'AGE' named entity 'high risk' named entity 'Autoimmune hemolytic anemia' named entity 'mortality rate' named entity 'acute respiratory distress syndrome' named entity 'monoclonal antibodies' named entity 'immunosuppression' named entity 'methylprednisolone' named entity 'AIHA' named entity 'methylprednisolone' named entity 'refractory' named entity 'high-dose' named entity 'immunosuppressive drugs' named entity 'Serologic tests' named entity 'therapeutic strategies' named entity 'continuous positive airway pressure' named entity 'ECMO' named entity 'ARDS' named entity 'IgA' named entity 'amikacin' named entity 'methylprednisolone' named entity 'WBC' named entity 'leukocyte count' named entity 'nitric oxide' named entity 'ECMO' named entity 'surgical treatment' named entity 'gas exchange' named entity 'WBC' named entity 'Autoimmune hemolytic anemia' named entity 'Maquet' named entity 'hemolysis' named entity '0.9' named entity 'ECMO' named entity 'steroid' named entity 'microbial' named entity 'protein' named entity 'cyclophosphamide' named entity 'immunoglobulin' named entity 'hemolysis' named entity 'immunosuppressive drugs' named entity 'mechanical ventilation' named entity 'gas exchange' named entity 'surfactant' named entity 'respiratory conditions' named entity 'PEEP' named entity 'AIHA' named entity 'blood flow' named entity 'methylprednisolone' named entity 'rituximab' named entity 'alemtuzumab' named entity 'prophylaxis' named entity 'follow-up' named entity 'computed tomography' named entity 'infusion' named entity 'gas exchange' named entity 'CT scan' named entity 'Serological' named entity 'AIHA' named entity 'immunosuppressive therapy' named entity 'young children' named entity 'ICU' named entity 'Aspergillus' named entity 'refractory' named entity 'intensive care unit' named entity 'caspofungin' named entity 'IgG' named entity 'acute respiratory distress syndrome'

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