Given the initial CSF result showing elevated proteins (65mg/dl), ongoing myoclonus, and the newly developed vasogenic edema on MRI, the decision was made by neurology at this point, to start a 3-day course of pulse dose steroids (solumedrol
1 gm IV/daily) for possible autoimmune encephalitis (AE) while awaiting the finalized autoimmune workup [9,10].
Most autoimmune encephalitis tends to be responsive to steroids, typically prescribed as solumedrol
1 g IV daily for 3-5 days followed by a taper [1, 3, 6].
and mycophenolate mofetil were added for treatment of presumed lupus nephritis and serositis in the setting of a negative infectious workup.
Induction therapy consisted of basiliximab and solumedrol
. Maintenance therapy was with tacrolimus, mycophenolate mofetil, and prednisone.
The patient was diagnosed with dermatomyositis and concomitant MPA and was treated with 3 days of solumedrol
1 g, followed by prednisone 60 mg daily and one-time intravenous cyclophosphamide 700 mg, followed by daily oral cyclophosphamide 150 mg.
She received 1 dose each of intramuscular (IM) epinephrine 0.3mg, IV solumedrol
125mg, IV benadryl 50mg, IV famotidine 20mg as initial management of anaphylaxis.
--Iniciar a infusao das pre-medicacoes e hidratacao conforme prescricao medica: ondanzentrona 8 mg, manitol 150 ml, solumedrol
125 mg, difenidramina 50 mg e SF 0,9% 1000 ml, 1 hora e 30 minutos antes do horario marcado para o inicio do transplante.
Do you really need material safety data sheets for every liquid in the office, including the solumedrol
for injection in your cabinet?
For the initial treatment of CDI, 44% received oral metronidazole, 32.5% received oral vancomycin, and 11% received intravenous solumedrol
. Seven patients (16%) had more than one CDI (occurring >8 weeks after completion of treatment and resolution of symptoms), and two patients had multiple recurrences.
Lab Results Ferritin 1237 ng/mL Iron 17 mcg/dL TIBC 184 mcg/dL CRP 2.0 mg/dL ESR 40 mm/hr ANA-negative Anti-dsDNA 34IU, low positive ANCA negative C3 31 mg/dL C4 5 mg/dL Cyclic citrulline peptide negative Rheumatoid factor 66 IU/mL DAT negative ASO negative Anti-MPO/RNP negative Direct Coombs positive Anti-cardiolipin negative Anti-smith negative Anti-SSA negative Anti-SSB negative Anti-histone negative Serine protease negative Cryoglobulin no precipitate Based on several weakly positive results along with a high ferritin, we started patient on low dose steroid treatment with 20 mg IV solumedrol
twice a day.
On day 4, he was started on Solumedrol
1000 mg IV daily and sodium valproate (VPA).
The prime consisted of: 1.5 l Hartman's solution, 0.1l 10% mannitol and 500 mg Solumedrol
. Bypass flows were maintained at 2.4 l/min2 body surface area.