RESUMO
Many people with sickle cell disease (SCD) or other anemias require chronic blood transfusions, which often causes iron overload that requires chelation therapy. The iron chelator deferiprone is frequently used in individuals with thalassemia syndromes, but data in patients with SCD are limited. This open-label study assessed the efficacy and safety of deferiprone in patients with SCD or other anemias receiving chronic transfusion therapy. A total of 228 patients (mean age: 16.9 [range, 3-59] years; 46.9% female) were randomized to receive either oral deferiprone (n = 152) or subcutaneous deferoxamine (n = 76). The primary endpoint was change from baseline at 12 months in liver iron concentration (LIC), assessed by R2* magnetic resonance imaging (MRI). The least squares mean (standard error) change in LIC was -4.04 (0.48) mg/g dry weight for deferiprone vs -4.45 (0.57) mg/g dry weight for deferoxamine, with noninferiority of deferiprone to deferoxamine demonstrated by analysis of covariance (least squares mean difference 0.40 [0.56]; 96.01% confidence interval, -0.76 to 1.57). Noninferiority of deferiprone was also shown for both cardiac T2* MRI and serum ferritin. Rates of overall adverse events (AEs), treatment-related AEs, serious AEs, and AEs leading to withdrawal did not differ significantly between the groups. AEs related to deferiprone treatment included abdominal pain (17.1% of patients), vomiting (14.5%), pyrexia (9.2%), increased alanine transferase (9.2%) and aspartate transferase levels (9.2%), neutropenia (2.6%), and agranulocytosis (0.7%). The efficacy and safety profiles of deferiprone were acceptable and consistent with those seen in patients with transfusion-dependent thalassemia. This trial study was registered at www://clinicaltrials.gov as #NCT02041299.
Assuntos
Anemia Falciforme , Sobrecarga de Ferro , Talassemia , Adolescente , Anemia Falciforme/complicações , Anemia Falciforme/tratamento farmacológico , Transfusão de Sangue , Deferiprona/uso terapêutico , Desferroxamina/efeitos adversos , Feminino , Humanos , Quelantes de Ferro/efeitos adversos , Sobrecarga de Ferro/tratamento farmacológico , Sobrecarga de Ferro/etiologia , Masculino , Piridonas/efeitos adversos , Talassemia/complicações , Talassemia/tratamento farmacológico , TransferasesRESUMO
Reinfection with SARS-CoV-2 is a rare phenomenon. To date, there has been some cases reported from countries such as United States, Ecuador, Hong Kong, the Netherlands and Belgium. This case report presents the first case of reinfection from Saudi Arabia, and probably the first dental student to have been re-infected with COVID-19. A 24-year-old male dental student presents with reinfection after a period of three months since he was first infected with COVID-19. The signs and symptoms reported by the patient were similar in both instances, except that he developed fever only at the time of reinfection. The infection and reinfection were confirmed with a RT-PCR test reports. This report highlights how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all health workers after healed from covid-19 or asymptomatic positive, since as seen sometimes the infection does not ensures complete immunity in 100% of cases.