Cyclophosphamide
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Cyclophosphamide Lack of efficacy: case report
A 6-year-old boy exhibited lack of efficacy following treatment with cyclophosphamide for diffuse alveolar haemorrhage. The boy was hospitalised on 01 April 2020 with palpable purpuric maculopapular rash and signs of arthritis. Following subsequent evaluation, he was diagnosed with Henoch–Schonlein purpura (HSP). He was treated with ibuprofen leading to improvement. He was discharged on hospital day 3. Two days later, he was re-hospitalised with tachypnoea, dyspnea, fever and abdominal pain. His COVID-19 rapid test was negative. However, based on presentation, a clinical diagnosis of COVID-19 was made. Exacerbation of HSP was also suspected. He was admitted to the paediatric ICU. Thereafter, he was treated with hydroxychloroquine, azithromycin, cloxacillin and prednisolone. However, his condition worsened. A repeat COVID-19 rapid test revealed negative result. Therefore, pulmonary haemorrhage secondary to HSP was suspected. Bronchoscopy and bronchoalveolar lavage (BAL) revealed diffuse alveolar hemorrhage. The BAL specimen tested negative for SARS-CoV-2. He started receiving IV cyclophosphamide [dosage not stated] for diffuse alveolar haemorrhage. However, cyclophosphamide therapy was not successful. Subsequently, he died due to respiratory failure. Mousavi MS, et al. COVID-19 in IGA vasculitis. Iranian Journal of Pediatrics 30: 1-2, No. 4, 2020. Available from: URL: http://doi.org/10.5812/ijp.104424
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Reactions 26 Sep 2020 No. 1823
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