Low-dose oral hydroxychloroquine led to impaired vision in a child with renal failure: Case report and literature review.

INTRODUCTION: Hydroxychloroquine (HCQ) has received much attention in the treatment of coronavirus disease 2019 recently. However, it can cause irreversible vision loss. Few cases have been reported in pediatric patient with HCQ-related adverse reactions. Appropriate administration and early disease recognition are important for reducing the adverse drug reactions of HCQ. PATIENT CONCERNS: We report a case of a 14-year-old Chinese girl who sought treatment for rapidly decreasing vision in the left eye over 3 days. The simulation results of the population pharmacokinetic model of HCQ revealed that the plasma concentration of HCQ abnormally increased before the visual acuity of the eye decreased. DIAGNOSIS: She was diagnosed as HCQ related drug adverse reaction. INTERVENTIONS: The daily dose of HCQ for this patient was adjusted from 100 mg/d to 50 mg/d. OUTCOMES: Follow-up for 6 months showed no more vision loss recurrence. However, the existing decreased visual acuity of the eye did not recover either. CONCLUSION: Although decreased visual acuity is an infrequent symptom, ophthalmologists should be aware of the possibility of HCQ concentration enrichment and consider minimizing HCQ use when a child with renal hypofunction seeks treatment for shortsightedness.

Clinical Pharmaceutical Care and Interpretation of Children with COVID-19

OBJECTIVE: To investigate the methods of pharmaceutical treatment and care of COVID-19 in child by clinical pharmacist. METHODS: Clinical pharmacist was involved in the treatment of the first case of COVID-19 in child in our hospital and provided the full range of clinical pharmacy services, assisting phyicians to optimize the medication regimen, on the basis of the patient's condition and laboratory results,combined with clinical practice. Potential drug interactions and adverse reactions were analyzed during treatment through drug recombination and monitor the efficacy of therapy. RESULTS: The child was treated with traditional Chinese medicine by orally, inhaled atomized interferon antivira and was RT-PCR negative for SARS-CoV-2 after treatment. CONCLUSION: Clinical pharmacists should use pharmaceutical care as an entry point to participate in the prevention and treatment of COVID-19. The drug monitoring service will conductive to improving the effectiveness, rationality, and safety of children's medication while improving medication compliance.