RT Journal Article
T1 Case Report: Successful Response to Intravenous Immunoglobulin and Steroid Pulses in a Renal Transplant Recipient With Severe Covid-19 Disease and Associated Acute Allograft Failure
A1 Rosa-Guerrero, Pedro
A1 Trujillo-Aguilera, Antonio
A1 Molina, Juan
A1 Navas, Ana
A1 López-Martín, Cristina
A1 Jurado, Aurora
A1 Rodríguez-Benot, Alberto
A1 Torres-De-Rueda, Álvaro
K1 COVID-19
K1 SARS-CoV-2
K1 Kidney transplantation
K1 Intravenous immunoglobulin
K1 Steroids
K1 Cytokine storm
K1 Case report
K1 C-reactive protein
K1 6-methylprednisolone
K1 Immunosuppression
K1 Immunosuppressive
K1 Hemodialysis
K1 Allograft
K1 Ferritin
K1 Trasplante de riñón
K1 Inmunoglobulinas intravenosas
K1 Esteroides
K1 Síndrome de liberación de citoquinas
K1 Proteína C-reactiva
K1 Metilprednisolona
K1 Terapia de inmunosupresión
K1 Inmunosupresores
K1 Diálisis renal
K1 Aloinjertos
K1 Ferritinas
AB The impact of Covid-19 pneumonia caused by SARS-CoV-2 on transplanted populations under chronic immunosuppression seems to be greater than in normal population. Clinical management of the disease, particularly in those patients worsening after a cytokine storm, with or without allograft impairment and using available therapeutic approaches in the absence of specific drugs to fight against the virus, involves a major challenge for physicians. We herein provide evidence of the usefulness of high-dose intravenous immunoglobulin (IVIG) combined with steroid pulses to successfully treat a case of Covid-19 pneumonia in a single-kidney transplanted patient with mechanical ventilation and hemodialysis requirements in the setting of a cytokine storm. A rapid decrease in the serum level of inflammatory cytokines, particularly IL-6, IL-8, TNF-α, MCP-1 and IL-10, as well as of acute-phase reactants such as ferritin, D-dimer and C-reactive protein was observed after the IVIG infusion and methylprednisolone bolus administration with a parallel clinical improvement and progressive allograft function recovery, allowing the patient's final discharge 40 days after the treatment onset. The immunomodulatory effect of IVIG together with the anti-inflammatory and immunosuppressive potential of steroids could be an alternative strategy to treat severe cases of Covid-19 pneumonia associated with an uncontrolled inflammatory response in transplanted populations.
PB Frontiers
YR 2021
FD 2021-05-11
LK http://hdl.handle.net/10668/4408
UL http://hdl.handle.net/10668/4408
LA en
NO Rosa-Guerrero P, Trujillo-Aguilera A, Molina J, Navas A, López-Martín C, Jurado A, et al. Case Report: Successful Response to Intravenous Immunoglobulin and Steroid Pulses in a Renal Transplant Recipient With Severe Covid-19 Disease and Associated Acute Allograft Failure. Front Immunol. 2021 May 11;12:671013
DS RISalud
RD Apr 7, 2025