Cyclophosphamide
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Neutropenia: case report A 70-year-old woman developed neutropenia during treatment with cyclophosphamide for neuropsychiatric systemic lupus erythematosus (SLE). The woman was admitted to the hospital with cognitive dysfunction and gait disturbance. Her medical history was significant for a previous diagnosis of acute cerebral infarction in the right corona radiata that was diagnosed by another physician and had been receiving aspirin for prophylaxis against future cerebral infarctions. On admission, based on the laboratory findings, she was diagnosed with systemic lupus erythematosus. Additionally, she was diagnosed with neuropsychiatric SLE based on her neurological symptoms. She started receiving treatment with 3 pulses of IV cyclophosphamide 750mg once every 4 weeks along with methylprednisolone and prednisolone. After receiving the second cycle of cyclophosphamide, she developed neutropenia secondary to cyclophosphamide therapy. The woman’s dose of cyclophosphamide was reduced to 500mg. Subsequently, she was found to have acute cerebral infarction and positive anti-phosphatidylserine/prothrombin antibodies, therefore, warfarin therapy was added to aspirin while monitoring her for antiphospholipid syndrome [outcome not stated]. Author comment: "Following the second cycle of [intravenous cyclophosphamide], we reduced the dose to 500 mg due to neutropenia." Fujita Y, et al. Reversible cognitive dysfunction in elderly-onset systemic lupus erythematosus, successfully treated with aggressive immunosuppressive therapy. Internal Medicine 57: 3025-3028, No. 20, 2018. Available from: URL: http:// 803438086 doi.org/10.2169/internalmedicine.0934-18 - Japan
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Reactions 7 Dec 2019 No. 1782
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