Presentation
IS-related serious adverse events (SAE) were reported in 47% of patients, with 4 presenting with cytomegalovirus infection and 4 (age, 42-59 years) diagnosed with cancer. [ncbi.nlm.nih.gov]
Entire Body System
- Intermittent Fever
The patient experienced intermittent fevers, polyarthralgia, and acute renal failure 9 days after completion of thymoglobulin administration. The patient's symptoms resolved rapidly and completely with a course of intravenous steroids. [ncbi.nlm.nih.gov]
Jaw & Teeth
- Jaw Pain
Jaw pain appears to be a hallmark symptom, and treatment with plasmapheresis and steroids relieves symptoms more rapidly than steroids alone. [ncbi.nlm.nih.gov]
Musculoskeletal
- Neck Pain
On day +4, he developed neck pain and global headache. His blood pressure (BP) was normal and there was no focal deficit. Injectable tramadol was given for pain relief. [neurologyindia.com]
Neurologic
- Generalized Tonic-Clonic Seizure
On day +5, he had a generalized tonic clonic seizure controlled by intravenous phenytoin. BP was elevated (174/100 mm of Hg) for which he was given oral amlodipine. Serum electrolytes were normal. [neurologyindia.com]
Workup
Skin Test
- Anergy
PD-1 expression on T cells can occur from recent activation or exposure to chronic stimulation that can induce anergy or exhaustion. PD-1 was transiently upregulated on Tregs, suggesting acute activation. [diabetes.diabetesjournals.org]
Treatment
The patient's symptoms resolved after 13 days on treatment with a short course of high-dose steroids for 3 days, followed by a prednisolone taper. [ncbi.nlm.nih.gov]
Prognosis
The clinical course was progressive and poor prognosis. [ncbi.nlm.nih.gov]
Historically, patients with severe aplastic anemia had a poor prognosis. [jamanetwork.com]
Introduction The worse prognosis of severe aplastic anemia (SAA) patients were not improved until the introduction of bone marrow transplant (BMT) and immunosuppressive therapy (IST) by antithymocyte globulin (ATG) [1], [2], [3], [4]. [journals.plos.org]
Influence of surveillance renal allograft biopsy on diagnosis and prognosis of polyomavirus-associated nephropathy. Kidney Int. 2003;64(2):665–673. 66. Hirsch HH, Knowles W, Dickenmann M, et al. [dovepress.com]
Etiology
Response rate did not appear to be influenced by age, sex, etiology, initial blood count, interval prior to ATG therapy, or dose of ATG employed. Complications were minimal and included minor urticarial reactions and intermittent fever. [ncbi.nlm.nih.gov]
Epidemiology
One may hypothesize that the observed association constitutes another element of the "paradoxical" epidemiology seen in HF patients, where reduced fat mass, low cholesterol, and low blood pressure are linked with increased mortality. [revespcardiol.org]
Median creatinine of 6 patients excluded for acute kidney insufficiency at time of IVUS was 3.95 mg/dL with an estimated glomerular filtration rate of 17 mL/min by the 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. [ahajournals.org]
Epidemiology of BK virus in renal allograft recipients: independent risk factors for BK virus replication. Transplantation. 2008;86(4):521–528. 62. Dharnidharka VR, Cherikh WS, Abbott KC. [dovepress.com]
Pathophysiology
Although intravascular hemolysis after ATG administration appears to be uncommon, the clinical consequences may be severe, and determining the pathophysiology may yield clues to the mechanism of intravascular hemolysis. [ncbi.nlm.nih.gov]
In spite of the frequency of side effects, including anemia and thrombocytopenia, their pathophysiological mechanisms are not clearly established. [hal.inserm.fr]
On the basis of the immunologic pathophysiology of familial hemophagocytic lymphohistiocytosis, we propose a therapy with a combination of antithymocyte globulins with corticosteroids, cyclosporin A, and intrathecal injections of methotrexate. [pediatrics.aappublications.org]
Myelodysplastic syndrome and aplastic anemia—distinct entities or dieases linked by a common pathophysiology? Semin Hematol.2000;37:15-29.Google Scholar 30. Maciejewski JP, Risitano AM, Nunez O, Young NS. [jamanetwork.com]
Current concepts in the pathophysiology and treatment of aplastic anemia. Blood. 2006;108:2509–19. [ Links ] 2. Naveiras O, Nardi V, Wenzel PL, Hauschka PV, Fahey F, Daley GQ. [scielo.br]
Prevention
[…] and Implants 1 4 Completed Prevention Leukemia, GVHD, ATG, Transplantation 1 4 Completed Prevention Transplant; Failure, Kidney 1 4 Completed Prevention Transplantation, Kidney 1 Manufacturers Not Available Packagers Genzyme Inc. [go.drugbank.com]
We believe physicians should be aware of this common toxicity immediately after the administration of ATG to avoid any potential hepatotoxic drug before the resolution and to prevent any risk of hemorrhagic accident. [ncbi.nlm.nih.gov]
The uses of this drug include the prevention and treatment of transplant rejection, aplastic anemia, and other conditions in which immunosuppression may be indicated. [medicinenet.com]
[…] anti-thymocyte globulin : a mixture of usually IgG antibodies against human T cells that is derived from purified animal blood serum (as from a horse or rabbit) and is administered by intravenous injection especially to suppress immune system function (as to prevent [merriam-webster.com]