Reactions 1680, p103 - 2 Dec 2017 Cyclophosphamide/ methylprednisolone/prednisone Various toxicities: case report A 75-year-old woman developed herpes zoster, influenza A infection, bacteraemia secondary to the Rothia species following treatment with methylprednisolone, cyclophosphamide and prednisone. The woman, who was diagnosed with IgA nephropathy with superimposed pauci-immune anti-neutrophilic cytoplasmic antibody (ANCA)- associated crescentic glomerulonephritis, received three doses of IV methylprednisolone 1000 mg/day, followed by oral prednisone 60 mg/day, in the hospital. Following a renal biopsy after the initial treatment, IV cyclophosphamide 700mg was administered on day 12 of hospitalisation. Later, she was discharged. One month thereafter, she received her second dose of cyclophosphamide. Eight days later, she was admitted to the ICU for generalised malaise and fever with a right-sided vesicular rash in a dermatomal distribution on the trunk, suggesting herpes zoster. The woman was treated with acyclovir. Subsequently, she developed influenza A infection, bacteraemia secondary to the Rothia species and diarrhoea [not all durations of treatments to reactions onset stated]. Thus, she received treatment with metronidazole, vancomycin and oseltamivir. Consequently, she recovered from all the infections. Author comment: "Unfortunately, most immunosuppressive regimens carry life-threatening risks including infection-related complications, especially in the elderly population." Nissaisorakarn P, et al. ANCA and IgA glomerulonephritis all in one: Prognosis and complications. BMJ Case Reports 2017: 9 Oct 2017. Available from: URL: http://doi.org/10.1136/bcr-2017-222080 - USA 803285410 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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