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Title: Clinical benefits of Tocilizumab in COVID‐19‐related cytokine release syndrome in a patient with end‐stage kidney disease on haemodialysis in Australia.
Epworth Authors: Stephen, Shiny
Park, Yeung‐Ae
Chrysostomou, Anastasia
Keywords: Covid-19
Cytokine Release Syndrome
Kidney Failure
Chronic Kidney Disease
UroRenal and Vascular Clinical Institute, Epworth HealthCare, Victoria, Australia
Internal Medicine Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Nov-2020
Publisher: Wiley
Citation: 25(11):845-849.
Abstract: COVID‐19 remains a global pandemic with more than 10 million cases and half a million deaths worldwide. The disease manifestations in patients with chronic kidney disease and especially those on haemodialysis are still being understood, with only a few overseas case series, and small observational trials thus far. It appears that the disease is more severe in this patient cohort. Part of the pathophysiology of severe COVID‐19 is related to accompanying cytokine release syndrome (CRS). Tocilizumab, an interleukin‐6 inhibitor, has been trialled for treatment of CRS in COVID‐19, but not yet approved. We present a case of an Australian patient on long‐term haemodialysis with severe COVID‐19 who was successfully treated with Tocilizumab. The peak of her illness was on day 7, with a C‐reactive protein of 624 mg/L (reference < 5 mg/L), ferritin of 5293 ng/mL (reference 30‐500 ng/mL), and interleukin‐6 level 1959.7 pg/mL, consistent with CRS. She was severely hypoxic on a ventilator, with rising inotropic requirements. With the use of Tocilizumab, there was a significant and immediate response in her inflammatory markers, and she made a steady recovery. The patient was discharged home 6 weeks after presentation.
PubMed URL:
ISSN: 1440-1797
Journal Title: Nephrology
Type: Journal Article
Affiliated Organisations: Department of General Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
The University of Melbourne, Parkville, Victoria, Australia.
Type of Clinical Study or Trial: Case Reports
Appears in Collections:UroRenal, Vascular

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