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Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia
Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia...
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Published in: | Tropical doctor 2013-04, Vol.43 (2), p.49-53 |
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description | Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P |
doi_str_mv | 10.1177/0049475513486642 |
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The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P < 0.001). No one in the intervention group died. It seems that high-dose methylprednisolone is effective in the treatment of patients with CCHF. The increased platelet count and reduction of blood product requirement for severe CCHF patients after receiving HDMP are promising results. Further investigation is necessary in order to determine the efficacy of corticosteroid and its effect on outcome.</description><identifier>ISSN: 0049-4755</identifier><identifier>EISSN: 1758-1133</identifier><identifier>DOI: 10.1177/0049475513486642</identifier><identifier>PMID: 23796671</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Administration, Oral ; Adult ; Aged ; Antiviral Agents - administration & dosage ; Drug Therapy, Combination ; Female ; Glucocorticoids - administration & dosage ; Hemorrhagic Fever, Crimean - drug therapy ; Humans ; Male ; Methylprednisolone - administration & dosage ; Middle Aged ; Ribavirin - administration & dosage ; Thrombocytopenia - drug therapy ; Young Adult</subject><ispartof>Tropical doctor, 2013-04, Vol.43 (2), p.49-53</ispartof><rights>The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c337t-b5751e3cd443a78e7c1cd8c50f9889b8aaf5e7888e9565aa5118af0fecf665603</citedby><cites>FETCH-LOGICAL-c337t-b5751e3cd443a78e7c1cd8c50f9889b8aaf5e7888e9565aa5118af0fecf665603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925,79364</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23796671$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sharifi-Mood, Batool</creatorcontrib><creatorcontrib>Alavi-Naini, Roya</creatorcontrib><creatorcontrib>Metanat, Maliheh</creatorcontrib><creatorcontrib>Mohammadi, Mehdi</creatorcontrib><creatorcontrib>Shakeri, Asad</creatorcontrib><creatorcontrib>Amjadi, Ali</creatorcontrib><title>Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia</title><title>Tropical doctor</title><addtitle>Trop Doct</addtitle><description>Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P < 0.001). No one in the intervention group died. It seems that high-dose methylprednisolone is effective in the treatment of patients with CCHF. The increased platelet count and reduction of blood product requirement for severe CCHF patients after receiving HDMP are promising results. Further investigation is necessary in order to determine the efficacy of corticosteroid and its effect on outcome.</description><subject>Administration, Oral</subject><subject>Adult</subject><subject>Aged</subject><subject>Antiviral Agents - administration & dosage</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Hemorrhagic Fever, Crimean - drug therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Methylprednisolone - administration & dosage</subject><subject>Middle Aged</subject><subject>Ribavirin - administration & dosage</subject><subject>Thrombocytopenia - drug therapy</subject><subject>Young Adult</subject><issn>0049-4755</issn><issn>1758-1133</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp1kL1PwzAUxC0EouVjZ0IeWQJ2HcfOiKryIVVigTl6dZ4bo8QOdlrU_55UBQYkpvek-91Jd4RccXbLuVJ3jOVlrqTkItdFkc-OyJQrqTPOhTgm072c7fUJOUvpnTEhueSnZDITqiwKxadku7DWGTA7Gixt3LrJ6pCQdjg0u7aPWHuXQhs8UudpD4NDPyT66YaGzqPrEHw2D34daAPYhRgbWDtDLW4xUvA1TfsP6dDE0K2C2Q2hR-_ggpxYaBNeft9z8vaweJ0_ZcuXx-f5_TIzQqghW0klOQpT57kApVEZbmptJLOl1uVKA1iJSmuNpSwkgORcg2UWjS0KWTBxTm4OuX0MHxtMQ9W5ZLBtwWPYpIoLNWNKSzYbUXZATQwpRbRVPxaEuKs4q_ZrV3_XHi3X3-mbVYf1r-Fn3hHIDkCCNVbvYRP92Pb_wC9kZIl6</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Sharifi-Mood, Batool</creator><creator>Alavi-Naini, Roya</creator><creator>Metanat, Maliheh</creator><creator>Mohammadi, Mehdi</creator><creator>Shakeri, Asad</creator><creator>Amjadi, Ali</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia</title><author>Sharifi-Mood, Batool ; Alavi-Naini, Roya ; Metanat, Maliheh ; Mohammadi, Mehdi ; Shakeri, Asad ; Amjadi, Ali</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c337t-b5751e3cd443a78e7c1cd8c50f9889b8aaf5e7888e9565aa5118af0fecf665603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Administration, Oral</topic><topic>Adult</topic><topic>Aged</topic><topic>Antiviral Agents - administration & dosage</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Hemorrhagic Fever, Crimean - drug therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Methylprednisolone - administration & dosage</topic><topic>Middle Aged</topic><topic>Ribavirin - administration & dosage</topic><topic>Thrombocytopenia - drug therapy</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sharifi-Mood, Batool</creatorcontrib><creatorcontrib>Alavi-Naini, Roya</creatorcontrib><creatorcontrib>Metanat, Maliheh</creatorcontrib><creatorcontrib>Mohammadi, Mehdi</creatorcontrib><creatorcontrib>Shakeri, Asad</creatorcontrib><creatorcontrib>Amjadi, Ali</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Tropical doctor</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sharifi-Mood, Batool</au><au>Alavi-Naini, Roya</au><au>Metanat, Maliheh</au><au>Mohammadi, Mehdi</au><au>Shakeri, Asad</au><au>Amjadi, Ali</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia</atitle><jtitle>Tropical doctor</jtitle><addtitle>Trop Doct</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>43</volume><issue>2</issue><spage>49</spage><epage>53</epage><pages>49-53</pages><issn>0049-4755</issn><eissn>1758-1133</eissn><abstract>Crimean-Congo haemorrhagic fever (CCHF) is an acute viral haemorrhagic disease that is now endemic in south eastern Iran. The most important factor associated with mortality is a platelet count of less than 50,000/mL. The purpose of this study is to compare treated cases with severe thrombocytopenia using ribavirin with high-dose methylprednisolone (HDMP) with patients receiving ribavirin without HDMP. A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) admitted to Boo-Ali Hospital in Zahedan between January 2010 and October 2011. The intervention group was given oral ribavirin, supportive managements and HDMP and the controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, the platelet count increased within 36 h and the leukocyte count within 48 h of the beginning of treatment. Fewer in the intervention group required a transfusion of blood products than in the controls (P < 0.001). No one in the intervention group died. It seems that high-dose methylprednisolone is effective in the treatment of patients with CCHF. The increased platelet count and reduction of blood product requirement for severe CCHF patients after receiving HDMP are promising results. Further investigation is necessary in order to determine the efficacy of corticosteroid and its effect on outcome.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>23796671</pmid><doi>10.1177/0049475513486642</doi><tpages>5</tpages></addata></record> |
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subjects | Administration, Oral Adult Aged Antiviral Agents - administration & dosage Drug Therapy, Combination Female Glucocorticoids - administration & dosage Hemorrhagic Fever, Crimean - drug therapy Humans Male Methylprednisolone - administration & dosage Middle Aged Ribavirin - administration & dosage Thrombocytopenia - drug therapy Young Adult |
title | Efficacy of high-dose methylprednisolone in patients with Crimean-Congo haemorrhagic fever and severe thrombocytopenia |
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