Successful Management of Severe Hyperhaemolysis with Combined Tocilizumab and Rituximab in Non-Transfusion-Dependent Thalassaemia: A Case Report
| Autor: | Amal M. El Afifi, Alia M. Saeed, Gihad H. Fekry, Mariam A. Mostafa, Reham A. Elmetwally, Inas M. Hamed, Aliaa N. Hussein, Gomaa M. Hasanien |
|---|---|
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Transfusion Medicine and Hemotherapy. :1-5 |
| ISSN: | 1660-3818 1660-3796 |
| Popis: | Introduction: This is the fourth case reporting the administration of tocilizumab to control hyperhaemolysis. It was administered with rituximab to stop hyperhaemolysis refractory to frontline therapy. Hyperhaemolysis is a rare life-threatening subtype of delayed haemolytic transfusion reaction. Refractory cases pose a clinical challenge with no standard of care to date. Case Presentation: A 29-year-old lady with non-transfusion-dependent thalassaemia presented with refractory hyperhaemolysis necessitating the administration of rituximab. This was complicated with anaemic heart failure and altered sensorium exacerbated with further transfusions. A nadir haemoglobin of 2.1 g/dL was reached after the initiation of rituximab, and her condition was too critical to wait for the slow expected improvement. Hence, tocilizumab was given as a bridging therapy to block haemolysis till the delayed onset of radical treatment. Conclusion: Tocilizumab can be effectively combined with rituximab to stop hyperhaemolytic episode refractory to first-line treatment when a prompt response is needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|