Subject(s)
Anti-Inflammatory Agents/therapeutic use , COVID-19/epidemiology , Immunologic Factors/therapeutic use , Prednisolone/therapeutic use , Rituximab/therapeutic use , Skin Diseases, Vesiculobullous/drug therapy , Adult , Autoimmune Diseases/drug therapy , Female , Hospitalization/statistics & numerical data , Humans , Iran/epidemiology , Male , Middle Aged , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Skin Diseases, Vesiculobullous/immunologyABSTRACT
This is a report of a case with mucous membrane pemphigoid (MMP) with severe eye involvement and concurrent COVID-19 treated successfully using simultaneous high dose intravenous immunoglobulin (IVIg) and anti-viral treatment as hydroxychloroquine, lopinavir/ritonavir, and ribavirin. He had finished a 2-g cycle of rituximab (RTX) in late January. He was receiving mycophenolate mofetil (MMF) for one month and 30 mg prednisolone for three months until his hospitalization. Prednisolone was tapered to 15 mg when current COVID-19 was suspected, considering his recent cough, dyspnea, and fever.
Subject(s)
Antiviral Agents/therapeutic use , Coronavirus Infections/therapy , Immunoglobulins, Intravenous/therapeutic use , Immunologic Factors/therapeutic use , Pemphigoid, Benign Mucous Membrane/therapy , Pneumonia, Viral/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnostic imaging , Coronavirus Infections/drug therapy , Deprescriptions , Diabetes Mellitus, Type 2/complications , Drug Combinations , Drug Therapy, Combination , Humans , Hypertension/complications , Iran , Lopinavir/therapeutic use , Male , Mycophenolic Acid/therapeutic use , Oseltamivir/therapeutic use , Pandemics , Pemphigoid, Benign Mucous Membrane/complications , Pneumonia, Viral/complications , Pneumonia, Viral/diagnostic imaging , Prednisolone/therapeutic use , Ritonavir/therapeutic use , Rituximab/therapeutic use , SARS-CoV-2 , Tomography, Spiral Computed , COVID-19 Drug TreatmentABSTRACT
Lumbar spinal stenosis (LSS) is a chronic and prevalent disease that occurs in 10.8% of the general population, mostly in old age. We designed the first clinical trial study to compare the effects of administering the nasal salmon calcitonin spray and gabapentin in patients with LSS. In this clinical trial, 90 patients with symptoms of neurogenic claudication and magnetic resonance imaging-proven LSS were randomly assigned to nasal salmon calcitonin, gabapentin, or placebo treatments for eight weeks (30 participants in each group). This was followed by a washout period of four weeks. After three months of study and after four weeks off the prescription, mean values of Oswestry Disability Index in the calcitonin, gabapentin, and control groups were 23 ± 12.05, 32 ± 16.08, and 38 ± 22.09, respectively (P ≤ 0.05, calcitonin group vs. gabapentin group, and P ≤ 0. 001, calcitonin group vs. control group with respect to pretreatment scores). Thus, three months after the treatment, although most of the patients in the control group had a satisfactory period of improvement, the improvement in the calcitonin group was more than the other two groups with a significant difference (P ≤ 0.05 when compared to gabapentin group and P ≤ 0.01 when compared to placebo group). We revealed that the 200 International Unit (IU) and nasal calcitonin spray daily are more effective compared to 300 mg gabapentin three times per day and the placebo effect for eight weeks of treatment of symptoms of patients with LSS.
