A novel approach in treating Tolosa-Hunt syndrome with injectable dexamethasone and cyclophosphamide: a case report

Aleesha Bind Shihab; Megha Ann George; K. Arun Chander Yadav; V. L. Arul Selvan

doi:10.18203/2319-2003.ijbcp20261970

Authors

Aleesha Bind Shihab Department of Clinical Pharmacology, Apollo Hospitals, Greams road, Chennai, Tamil Nadu, India
Megha Ann George Department of Clinical Pharmacology, Apollo Hospitals, Greams road, Chennai, Tamil Nadu, India
K. Arun Chander Yadav Department of Neurology, Apollo Hospitals, Greams road, Chennai, Tamil Nadu, India
V. L. Arul Selvan Department of Neurology, Apollo Hospitals, Greams road, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20261970

Keywords:

Tolosa Hunt syndrome, Immunoglobulin G4, Dexamethasone, Cyclophosphamide, Steroid, Steroid sparing agent

Abstract

This case report describes about the treatment efficacy of the combination therapy of injection dexamethasone followed by single dose of pulsed intravenous cyclophosphamide in a 53-year-old male patient diagnosed with Tolosa Hunt syndrome (THS) with normal immunoglobulin G4 (IgG4) level. This patient with history of type 2 diabetes mellitus, systemic hypertension, coronary artery disease presented with complaints of left sided headache, blurring of vision with diplopia. On further examination and investigation patient was diagnosed with THS. The patient was managed with intravenous steroid followed by single dose of intravenous steroid sparing agent. Treatment with intravenous steroid sparing agent led to rapid and significant clinical remission. He was discharged with a plan of combination therapy with oral steroid and steroid sparing agent and follow up recommendation.

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