Sanders Howard, Callas Christina, St Amant Helaine, Chung Jong, Dimitriades Victoria R, Nakra Natasha A
Department of Pediatrics, University of California Davis Medical School, Sacramento, CA, United States.
Division of Pediatric Hematology & Oncology, Department of Pediatrics, University of California Davis Medical School, Sacramento, CA, United States.
Front Pediatr. 2023 Mar 10;11:1076686. doi: 10.3389/fped.2023.1076686. eCollection 2023.
This report describes a pediatric patient who underwent chimeric antigen receptor (CAR) T-cell therapy for refractory B-cell acute lymphoblastic leukemia (B-ALL) four years prior, with resultant hypogammaglobulinemia for which he was receiving weekly subcutaneous immune globulin. He presented with persistent fever, dry cough, and a tingling sensation in his toes following a confirmed COVID-19 infection 3 weeks prior. His initial nasopharyngeal SARS-CoV-2 PCR was negative, leading to an extensive workup for other infections. He was ultimately diagnosed with persistent lower respiratory tract COVID-19 infection based on positive SARS-CoV-2 PCR from bronchoalveolar lavage (BAL) sampling. He was treated with a combination of remdesivir (antiviral) and casirivimab/imdevimab (combination monoclonal antibodies) with immediate improvement in fever, respiratory symptoms, and neurologic symptoms.
本报告描述了一名儿科患者，其在四年前接受了嵌合抗原受体（CAR）T细胞疗法治疗难治性B细胞急性淋巴细胞白血病（B-ALL），结果导致低丙种球蛋白血症，为此他每周接受皮下免疫球蛋白治疗。3周前确诊感染新型冠状病毒肺炎（COVID-19）后，他出现持续发热、干咳和脚趾刺痛感。他最初的鼻咽严重急性呼吸综合征冠状病毒2（SARS-CoV-2）聚合酶链反应（PCR）检测为阴性，因此对其他感染进行了全面检查。最终，根据支气管肺泡灌洗（BAL）采样的SARS-CoV-2 PCR阳性结果，他被诊断为持续性下呼吸道COVID-19感染。他接受了瑞德西韦（抗病毒药物）和卡西瑞维单抗/伊德维单抗（联合单克隆抗体）联合治疗，发热、呼吸道症状和神经症状立即得到改善。
