High-dose methylprednisolone pulse therapy is widely used in patients with severe COVID-19. This known to have sufficient clinical effectiveness, but the optimal administration method not known. In this study, we assessed deterioration of oxygenation after COVID-19 according disease severity (oxygen requirement) at initiation therapy. Ninety-nine who received Saitama Medical University Hospital...

Background Anti-N-methyl- d-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune neurological disorder that usually occurs as a paraneoplastic syndrome and is particularly associated with ovarian teratoma. Standard therapy for severe cases is not established and the prognosis in patients who do not respond to first-line treatment is poor. Case Report An 11-year-old boy complained ps...

BACKGROUND The lungs are involved in up to 70% of cases of leptospirosis. In the more severe forms-bleeding from the lungs and acute respiratory distress syndrome-the lethality is high. The treatment proposed for leptospirotic pneumonitis includes just care for patients in critical condition. Clinical and experimental studies point to the involvement of immunological mechanisms in the physiopat...

A 28 year old woman with systemic lupus erythematosus who developed chronic lupus peritonitis and ascites is described. Lupus peritonitis appeared with abdominal fullness, postprandial abdominal discomfort, and painless ascites. Four months later the patient developed vertigo, headaches, visual disturbances, serositis, and glomerulonephritis. Lupus peritonitis and the other disease manifestatio...

We report an 83-year-old diabetic male who presented with acute-onset renal failure, seizures, psychosis, pneumonia, and right foot gangrene. Investigations revealed thrombocytopenia, CSF lymphocytosis, ANA and dsDNA positivity, hypocomplementemia, and pneumonitis following which he was treated with pulse methylprednisolone. He was treated for Pseudomonas-related ventilator-associated pneumonia...

Pulse therapy with methylprednisolone became standard of care for the treatment of worsening lupus nephritis since its introduction in 1976. Even today, 40 years since its introduction, it is still a gold standard for this clinical condition. In this communication, we have reviewed the events that surrounded the use of this therapy by one of the authors of the original paper published in Lancet...

To the Editor: Survival following oral ingestion of a large volume of paraquat is rare. Our patient ingested approximately 200 ml of paraquat and survived, following aggressive intervention. He developed oral pharyngeal ulceration, acute lung injury, haematemesis, haemoptysis and renal failure. He was treated with a combination of pulse methylprednisolone, vitamins C and E, and N-acetylcysteine...

We describe a case of recurrent invasive thymoma associated with myasthenia gravis that responded to combined treatment with prednisolone and tacrolimus. The patient suffered from a myasthenic crisis and received methylprednisolone pulse therapy and partial thymomectomy. Low maintenance doses of prednisolone and tacrolimus shrank the size of the invasive thymoma and maintained the patient witho...