Compassionate use of Jusvinza in the treatment of a patient with severe Leptospirosis associated with the Jarisch Herxeimer reaction
Keywords:
Jusvinza, leptospirosis, Weil syndrome.Abstract
Introduction: Approximately 10% of human leptospirosis cases progress to severe forms, among which Weil syndrome stands out. This condition can be aggravated by complications associated with antibiotics, such as the Jarisch Herxeimer reaction (JHR) that intensifies inflammation. Treatment with Jusvinza may be an option for these states mediated by hyperinflammation.Objective: To describe the clinical evolution of a patient with leptospirosis and Weil's syndrome who developed the JHR and was treated with Jusvinza.
Case Report: 50-year-old male patient was diagnosed with Leptospirosis, which progressed to a serious condition and Weil syndrome and received treatment with ceftriaxone, as result he developed JHR, which led to the use of mechanical ventilation and the compassionate use of Jusvinza. The clinical, radiological, and humoral improvement was evident 48 hours after starting treatment.
Conclusions: Treatment with Jusvinza induced a decrease in several biomarkers of systemic inflammation and contributed to the patient's recovery. These results indicate that Jusvinza may be an effective option for the treatment of severe forms of Leptospirosis and its complications, associated with hyperinflammation.
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References
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2. Zamora A, Chang D, López Y. Leptospirosis y enfermedad de Weil. Revista Medica Sinergia. 2020; 3(5): e346. DOI: 10.31434/rms.v5i3.346
3. Guerrier G, D'Ortenzio E. The Jarisch-Herxheimer reaction in leptospirosis: a systematic review. PLoS One. 2013; 8(3):e59266. DOI: 10.1371/journal.pone.0059266
4. Hernández M, Mauri JL, Vargas J. Leptospirosis humana: un abordaje epidemiológico desde los factores ambientales. Rev Cubana Med Gen Integr. 2017; 33(1):129-38. Disponible en: http://www.revmgi.sld.cu/index.php/mgi/article/view/263/129
5. Butler T. The Jarisch-Herxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis. Am J Trop Med Hyg. 2017; 96(1):46-52. DOI: 10.4269/ajtmh.16-0434
6. Torres C. Enfermedad de Weil y hepatitis aguda multifactorial. A propósito de un caso. Rev Gastroenterolog. 2018; 41(4): 253-4. DOI: 10.1016/j.gastrohep.2017.04.004
7. Domínguez MC, Lorenzo N, Barberá A, Darrasse-Jeze G, Hernandez MV, Torres AM, et al. An altered peptide ligand corresponding to a novel epitope from heat-shock protein 60 induces regulatory T cells and suppresses pathogenic response in an animal model of adjuvant induced arthritis. Autoimmunity. 2011; 44:471-82. DOI: 10.3109/08916934.2010.550590
8. Prada D, Gómez J, Lorenzo N, Corrales O, et al. Phase I Clinical Trial with a Novel Altered Peptide Ligand Derived from Human Heat-Shock Protein 60 for Treatment of Rheumatoid Arthritis: Safety, Pharmacokinetics and Preliminary Therapeutic Effects. Journal of Clinical Trials. 2018; 8:2167-0870. DOI: 10.4172/2167-0870.1000339
9. Cabrales-Rico A, Ramos Y, Besada V, Del Carmen DM, Lorenzo N, et al. Development and validation of a bioanalytical method based on LC-MS/MS analysis for the quantitation of CIGB-814 peptide in plasma from Rheumatoid Arthritis patients. J Pharm. Biomed. Anal. 2017; 143: 130-40. DOI: 10.1016/j.jpba.2017.05.030
10. Venegas R, Peña R, Santana R. Péptido inmunomodulador CIGB-258 para el tratamiento de pacientes graves y críticos con la COVID-19. Rev Cub Med Milit. 2020; 49(4): e0200926. Disponible en: https://revmedmilitar.sld.cu/index.php/mil/article/view/926/625
11. Hernández-Cedeño M, Venegas-Rodriguez R, Peña-Ruiz R, Bequet-Romero M, Santana-Sánchez R, Pentón-Ariaset E, et al. CIGB-258, a peptide derived from human heat-shock protein 60, decreases hyperinflammation in COVID-19 patients. Cell Stress and Chaperones. 2020 [acceso: 24/02/2024]; 26(3): 515-25. DOI: 10.1007/s12192-021-01197-2
Published
2024-07-24
How to Cite
1.
Peña Ruiz RM, Venegas Rodriguez R, Santana Sánchez R, Santiesteban Licea BM, Rittoles Navarro A, Pérez Aguilera LM, et al. Compassionate use of Jusvinza in the treatment of a patient with severe Leptospirosis associated with the Jarisch Herxeimer reaction. Rev Cubana Med Milit [Internet]. 2024 Jul. 24 [cited 2025 Jan. 8];53(3):e024059934. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/59934
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