Severe prolonged neutropenia following administration of tocilizumab in a patient affected by COVID-19: a case report and brief review of the literature.

Tocilizumab is one of the newest therapeutic options for the acute respiratory distress syndrome (ARDS) caused by the recently discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ß-coronavirus. Several trials are currently ongoing to assess the efficacy and safety profile of tocilizumab in treating ARDS. In this article, we present the case of a Black patient with acute pneumonia who benefited greatly from tocilizumab, but developed severe prolonged neutropenia. Considering the increasing use of tocilizumab among patients with coronavirus disease 2019 (COVID-19), this case warrants further research regarding the possible adverse hematological effects that need to be monitored in order to prevent secondary infections.

Gastrointestinal Involvement in Children with Systemic Lupus Erythematosus.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder. When it presents before the age of 18 years (childhood-onset systemic lupus erythematosus, cSLE), the disease course tends to be more severe with a higher rate of organ involvement and requires an early diagnosis. Gastrointestinal involvement in cSLE is rare and scarcely reported in the literature. Any organ of the gastrointestinal system may be affected, either as a direct consequence of the disease, as a subsequent complication, or as an adverse drug event. Abdominal pain is the most common GI symptom, it can be diffuse or well localized, and can underline different conditions such as hepatitis, pancreatitis, appendicitis, peritonitis, or enteritis. cSLE may have an alteration of the intestinal barrier with features of protein-losing enteropathy or, in genetically predisposed patients, may develop associated autoimmune disorders such as Coeliac Disease or Autoimmune Hepatitis. The aim of this manuscript is to provide a narrative review of gastrointestinal manifestations in cSLE focused on hepatic, pancreatic, and intestinal involvement. A comprehensive literature search based on the PubMed database was performed.

Celiac crisis as the life-threatening onset of celiac disease in children: a case report.

Celiac disease (CD) is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. In rare cases, CD may occur with a severe potential life-threatening manifestation known as a celiac crisis (CC). This may be a consequence of a delayed diagnosis and expose patients to possible fatal complications. We report the case of a 22-month-old child admitted to our hospital for a CC characterized by weight loss, vomiting, and diarrhea associated with a malnutrition state. Early identification of symptoms of CC is essential to provide a prompt diagnosis and management.