Intravenous Immunoglobulin Therapy When Plasmapheresis Fails in Thrombotic Thrombocytopenic Purpura Associated with Severe ADAMTS 13 Deficiency in Childhood: A Case Report

Pavone, Piero; Passaniti, Eleonora; Taibi, R.; Longo, Margherita; Nunnari, Giuseppe; Verrotti, Alberto; Falsaperla, Raffaele; Cocuzza, S

doi:10.1177/1721727x1301100131

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…In the latter a study of metallo-protease ADAMST 13 showed a low value (<10%) with positive anti-ADAMTS 13 IgG and inhibitor, strengthening the hypothesis of an autoimmune process. 73 In addition, Corticosteroids have been widely used in infantile spasms and West Syndrome, and there is still a debate on their efficacy when compared with the historical used Vigabatrin therapy 74 On the basis of the large involvement of IL-1beta in immunemediated epileptogenesis, the compounds showing greatest promise belong to the group of inhibitors known as interleukin converting enzyme (ICE)/caspase-1, the proteases that catalyzes the conversion of the inactive precursor pro-IL-1beta to active IL-1beta. 75 This kind of inhibitor acts to reduce the release of IL-1beta in organotypic hippocampal slices following exposure to pro-inflammatory stimuli, 76 decreasing acute seizure activity following intra-hippocampal kainate in rats, 76 and restricts the generalization of seizures in a rapid kindling model.…”

Section: Immunotherapeutic Strategy In Epilepsy-a Focus On Inflammationmentioning

confidence: 99%

Targeting inflammation as a therapeutic strategy for drug-resistant epilepsies

Vitaliti

Pavone

Mahmood

et al. 2014

Human Vaccines & Immunotherapeutics

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An increasing body of literature data suggests that inflammation, and in particular neuroinflammation, is involved in the pathophysiology of particular forms of epilepsy and convulsive disorders. Animal models have been used to identify inflammatory triggers in epileptogenesis and inflammation has recently been shown to enhance seizures. For example, pharmacological blockade of the IL-1beta/IL-1 receptor type 1 axis during epileptogenesis has been demonstrated to provide neuroprotection in temporal lobe epilepsy. Furthermore, experimental models have suggested that neural damage and the onset of spontaneous recurrent seizures are modulated via complex interactions between innate and adaptive immunity. However, it has also been suggested that inflammation can occur as a result of epilepsy, since animal models have also shown that seizure activity can induce neuroinflammation, and that recurrent seizures maintain chronic inflammation, thereby perpetuating seizures. On the basis of these observations, it has been suggested that immune-mediated therapeutic strategies may be beneficial for treating some drug resistant epilepsies with an underlying demonstrable inflammatory process. Although the potential mechanisms of immunotherapeutic strategies in drug-resistant seizures have been extensively discussed, evidence on the efficacy of such therapy is limited. However, recent research efforts have been directed toward utilizing the potential therapeutic benefits of anti-inflammatory agents in neurological disease and these are now considered prime candidates in the ongoing search for novel anti-epileptic drugs. The objective of our review is to highlight the immunological features of the pathogenesis of seizures and to analyze possible immunotherapeutic approaches for drug resistant epilepsies that can alter the immune-mediated pathogenesis.

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Section: Immunotherapeutic Strategy In Epilepsy-a Focus On Inflammationmentioning

confidence: 99%

Targeting inflammation as a therapeutic strategy for drug-resistant epilepsies

Vitaliti

Pavone

Mahmood

et al. 2014

Human Vaccines & Immunotherapeutics

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Safety and Efficacy of a 10% Intravenous Immunoglobulin Preparation in Patients with Immune Thrombocytopenic Purpura: Results of Two International, Multicenter Studies

et al. 2016

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Which is Responsible for Bradycardia in Woman Treated for Incomplete Abortion and Thrombocytopenia? Intravenous Immunoglobulins, Methylprednisolone or Clindamycin

Ghasemian

Ghasemzadeh

Soleimany

2022

J Obstet Gynecol Cancer Res

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Clindamycin, IVIg, and corticosteroids are widely used in medicine. In this study, we represent an unusual case of sinus bradycardia following the administration of these drugs. The patient was a 31-year-old woman who presented a complaint of vaginal bleeding at Shahid Motahhari Hospital, Urmia, Iran. Vaginal examination revealed active bleeding. Laboratory tests reported a positive HCG level. Ultrasonography was performed, and the results showed the presence of retained products of conception. The patient became a candidate for curettage. The initial pulse rate was tachycardia. Laboratory data were reported, platelet count of 16000. Corticosteroids and IVIgs were started. Due to the possibility of infectious abortion, Clindamycin and Gentamicin was started. About 24 hours after curettage and 4 hours after starting clindamycin, the patient felt dizziness. Vital signs were obtained that PR: 38-40. We concluded that clindamycin and IVIg can result in severe bradycardia, even in patients with no previous cardiac history, especially when combined with corticosteroids. As a result, we recommend physicians be more cautious when administrating these medications.

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Intravenous Immunoglobulin Therapy When Plasmapheresis Fails in Thrombotic Thrombocytopenic Purpura Associated with Severe ADAMTS 13 Deficiency in Childhood: A Case Report

Cited by 3 publications

References 11 publications

Targeting inflammation as a therapeutic strategy for drug-resistant epilepsies

Targeting inflammation as a therapeutic strategy for drug-resistant epilepsies

Safety and Efficacy of a 10% Intravenous Immunoglobulin Preparation in Patients with Immune Thrombocytopenic Purpura: Results of Two International, Multicenter Studies

Which is Responsible for Bradycardia in Woman Treated for Incomplete Abortion and Thrombocytopenia? Intravenous Immunoglobulins, Methylprednisolone or Clindamycin

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