TY  - JOUR
AU  - Stephen, S
AU  - Park, Y-A
AU  - Chrysostomou, A
Y2  - 2020/12/16
Y1  - 2020/09/17
SN  - 1320-5358
UR  - http://hdl.handle.net/11343/254561
AB  - 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.
LA  - English
PB  - WILEY
T1  - Clinical benefits of Tocilizumab inCOVID-19-related cytokine release syndrome in a patient with end-stage kidney disease on haemodialysis in Australia
DO  - 10.1111/nep.13767
IS  - Nephrology
VL  - 25
IS  - 11
SP  - 845-849
ER  -