Table 1.
Therapeutic timeline of the patient
| Date | Major symptoms | Therapy |
|---|---|---|
|
2nd Jun 2016 (9 years old) |
Limb aches | Allogeneic hematopoietic stem cell transplantation; adding methylprednisolone tablets (12 mg, bid), cyclosporin (75 mg, bid) and mycophenolate mofetil (250 mg, bid) orally |
|
Jan 2017 (10 years old) |
Limb aches (alleviated) | Methylprednisolone (reducing dose to 8 mg, bid), cyclosporin (75 mg, bid) and mycophenolate mofetil (250 mg, bid) orally |
| Feb 2017 | Limb aches (alleviated) | Methylprednisolone (reducing dose to 4 mg, bid), cyclosporin (75 mg, bid) and mycophenolate mofetil (250 mg, qd) orally |
| Mar 2017 | No obvious symptoms | Cyclosporin (75 mg, bid) and mycophenolate mofetil (250 mg, qd) orally |
| Nov 2017 | Photophobia and hyperemia in patient’s left eye | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (1 mg, qd) as well as calcium carbonate and vitamin D3 chewable tablet (300 mg, qd) orally |
|
Jan 2018 (11 years old) |
Photophobia and hyperemia in patient’s left eye (worsened) | Ganciclovir (150 mg, bid), methylprednisolone (2 mg, bid) and cyclosporine (25 mg, qd) orally |
| Apr 2018 | Photophobia and hyperemia; Pain in hips (bilateral necrosis of the femoral osteoepiphysis was diagnosed) | Ganciclovir (150 mg, bid), methylprednisolone (2 mg, bid) and cyclosporine (increasing dosage to 75 mg, bid) orally |
| May 2018 | Photophobia and hyperemia (alleviated); Pain in hips (alleviated) |
Methylprednisolone was discontinued; tacrolimus capsules (2.5 mg, tid), sirolimus tablets (1 mg, qd) and cyclosporine (75 mg, bid) orally |
| 22nd May 2018 | Sore throat; oral ulcer; pain in hips, knees and ankles | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (1 mg, qd), cyclosporine (75 mg, bid) and ganciclovir (150 mg, bid) orally; rituximab (5 mg, qw, the first time) subcutaneously |
| 26th May 2018 | Sore throat; oral ulcer; hematuria; pain in hips, knees and ankles | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (increasing dosage to 2 mg, qd), cyclosporine (75 mg, bid) and ganciclovir (150 mg, bid) orally |
| 29th May 2018 | Sore throat (alleviated); oral ulcer(alleviated); hematuria; pain in hips, knees and ankles | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (increasing dosage to 2 mg, qd), cyclosporine (75 mg, bid) and ganciclovir (150 mg, bid) orally; rituximab (5 mg, qw, the second time) subcutaneously |
| 3rd Jun 2018 | Sore throat (alleviated); oral ulcer(alleviated); hematuria (alleviated); pain in hips, knees and ankles | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (increasing dosage to 2 mg, qd) and cyclosporine (75 mg, bid) orally; rituximab (5 mg, qw, the third time) subcutaneously |
| 10th Jun 2018 | Pain in hips, knees and ankles | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (increasing dosage to 2 mg, qd) and cyclosporine (75 mg, bid) orally; rituximab (5 mg, qw, the fourth time) subcutaneously |
| 19th Jun 2018 | Pain in hips, knees and ankles; vision loss | Tacrolimus capsules (2.5 mg, tid), sirolimus tablets (increasing dosage to 2 mg, qd) and cyclosporine (75 mg, bid) orally |