The Tohoku journal of experimental medicine
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Tohoku J. Exp. Med. · Sep 2024
Case ReportsSuccessful Combination of Fresh Frozen Plasma and Albumin 5% in Plasma Exchange for a Patient with Concurrent Thyroid Storm and Guillain-Barré Syndrome: A Rare Case Report.
Thyroid storm is an endocrine emergency, and treatment must ensure primary goals, including reducing the production and release of thyroid hormones, mitigating the effects of thyroid hormones, increasing the elimination of thyroid hormones, treating systemic disturbances, and managing triggering factors. However, in a few cases where thyroid storm does not respond to initial treatment, therapeutic plasma exchange (TPE) should be considered. A 50-year-old male patient was admitted to the University Medical Center Ho Chi Minh City due to hypotonia and sensory disturbances gradually spreading from the lower extremities to the entire body. ⋯ This reduces the drawbacks associated with high volumes of FFP and offers a balanced and effective approach to managing thyroid storms. Moreover, the concurrent presence of GBS and thyroid storm is extremely rare. Through this case, we aim to discuss the role of TPE in the treatment of thyroid storms and the effectiveness of the combination of FFP and albumin 5% as the replacement fluid.
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Tohoku J. Exp. Med. · Sep 2024
Meta AnalysisEfficacy and Safety of Neoadjuvant Pyrotinib for Human Epidermal Receptor 2-Positive Breast Cancer: A Meta-Analysis.
Neoadjuvant pyrotinib shows the potential to improve treatment response in human epidermal receptor 2 (HER2)-positive breast cancer patients, but relevant meta-analyses are scarce. This meta-analysis intended to explore the efficacy and safety of neoadjuvant pyrotinib for HER2-positive breast cancer patients. Studies comparing the efficacy and safety between HER2-positive breast cancer patients receiving pyrotinib-containing neoadjuvant treatment (pyrotinib group) and those receiving other neoadjuvant treatments (control group), were searched in EMBASE, Web of Science, Cochrane, PubMed, China National Knowledge Infrastructure, Wanfang, and SinoMed until December 2023. ⋯ Regarding adverse events, only the incidence of diarrhea was increased in the pyrotinib group versus the control group (RR = 1.97; 95% CI = 1.31-2.96; P = 0.001), while others were not different, including nausea and vomiting, leukopenia, thrombocytopenia, hand-foot syndrome, and alopecia (all P > 0.05). No publication bias existed, and sensitivity analysis suggested the satisfactory robustness of this meta-analysis. In conclusion, compared with other neoadjuvant treatments, pyrotinib-containing neoadjuvant treatment achieves a better treatment response with a good safety profile in HER2-positive breast cancer patients.