During the ongoing COVID-19 pandemic due to the SARS-CoV-2 virus of which evidence-based medical paradigms cannot be easily applied; difficult clinical decisions shall be required particularly in the 'difficult-to-treat' cases of high risk group with associated comorbidities. Convalescent immune plasma therapy is a promising option as a sort of 'rescue' treatment in COVID-19 immune syndrome, where miraculous antiviral drugs are not available yet. In this report, we aim to convey our experience of multi-task treatment approach with convalescent immune plasma and anti-cytokine drug combination in a COVID-19 patient with extremely challenging comorbidities including active myeloid malignancy, disseminated tuberculosis and kidney failure.
Background/aim
The SARS-CoV-2 infection was declared as a pandemic by the World Health Organization (WHO) on March 11, 2020, and the death toll from COVID-19, which is the disease caused by SARS-CoV-2, has already surpassed that of many previous epidemics. A wide variety of treatment options are being considered for COVID-19, but there is still no definitive treatment or vaccine. This study aims to explain the background of convalescent plasma (CP) treatment and its relations with COVID-19 immunity, to define ideal treatment procedures, and to reveal present and future perspectives in the light of the rapidly growing data.
Immunological basis of COVID-19-associated immune response and convalescent plasma as a treatment option
Since it has been shown that the impaired immune response of the host is one of the most important factors that increase the severity of the infection, treatment strategies to suppress aberrant immune activation are currently being considered. CP, which is derived from recently recovered patients and contains neutralizing antibodies and many other immunemodulatory substances, seems to be the most convenient strategy to restore normal immune function considering the fast spreading nature of the ongoing pandemic.
Conclusion
Even though mechanisms of action of plasma therapy are not fully delineated, it was shown that it could lead to a reduction in mortality since other alternatives such as monoclonal antibodies or SARS-CoV-2 hyperimmunoglobulin require much more time and effort to be developed.
Background Acute pancreatitis is a common cause of hospitalization among gastrointestinal disorders and its frequency has been rising in the past few years. The majority of cases are due to alcohol use, gallstones and hypertriglyceridemia. However, there still remain a significant number of cases in which no causative factor can be found and therefore called idiopathic. Contrast induced pancreatitis is a rare cause pancreatitis and there are only a few cases reported so far. Here we presented a case of mild acute pancreatitis following iodinated contrast exposure. Case Report A 42-year-old female patient with a history of lymphoma was admitted to our clinic with severe abdominal pain and nausea. Her blood tests revealed elevated pancreatic enzyme levels and mildly elevated liver function tests. Upper abdomen magnetic resonance imaging revealed pancreatic inflammation without any sign of necrosis. Since her complaints began after a computed tomography scan that she had earlier that day for the evaluation of lymphoma and no other cause could be found, iodinated contrast was thought to be the cause of acute pancreatitis in this patient. Conclusions Contrast agents seem to be a rare cause of acute pancreatitis, however taking the increasing availability of procedures involving radiocontrast agents into consideration, it is important to keep in mind that clinicians may come across more cases of contrast-induced acute pancreatitis in the future.
Background: sarcopenia is associated with poor prognosis and increased treatment toxicity in patients with cancer. However, there is limited data about sarcopenia and cardiotoxicity of chemotherapy. The aim of this study is to evaluate relationship between sarcopenia and anthracycline (AC) related cardiotoxicity.
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