PMC10332964_01
MRI showing diffuse swelling of the pancreas. Note the swollen pancreatic body and tail before the treatment (left). The swelling of the pancreas resolved after the steroid treatment (right).
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The patient was started on steroid treatment, which led to amelioration of the diffuse swelling of the pancreas (Fig. 1) and stricture of the main pancreatic duct (Fig. 2).
COVID-19 pandemic series in Japan. The trend in the number of newly confirmed cases (daily) is shown. The trend in the number of patients requiring inpatient care is also indicated. Our patient developed COVID-19 in the midst of the sixth wave of the pandemic in Japan (8).
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HEALGEN(R); (Takara Bio, Shiga, Japan)] performed by the administration of Yokohama City, and he was referred to our emergency unit in the midst of the sixth wave of the pandemic in Japan (Fig. 3).
Findings of chest computed tomography of the lung. Emergent chest CT revealed no evidence of SARS-CoV-2; however, given the potential risk of severe COVID-19, we decided to administer combined REGN-COV2 antibody infusion therapy at a dose of 500 mg over 30 minutes.
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Emergent chest computed tomography (CT) revealed no evidence of SARS-Cov-2 (Fig. 4), but based on the potential risk of severe COVID-19 for SARS-CoV-2, we decided to administer combined REGN-COV2 antibody infusion therapy at 500 mg over 30 minutes, after obtaining informed consent from the patient.
The mechanism of action and indications of antibody cocktail treatment are shown. The cocktail comprises two monoclonal antibodies, which are man-made proteins that mimic natural antibodies found in the immune system. They bind to non-overlapping portions of the SARS-CoV-2 spike protein in the key location at which the virus latches on to human cells, thereby preventing new viral particles from infecting further cells (8). This Figure was revised based on the homepage from https://www.koho.metro.tokyo.lg.jp/2021/10/01.html (11).
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On day 1, the antibody cocktail therapy [Fig. 5 ] was administered when the patient's body temperature was 38 C.
Clinical course. First, the patient was diagnosed with type 1 AIP with Mikulicz disease four years ago. He remained on maintenance steroid therapy for three years; however, his IgG4 levels did not stabilize. Nonetheless, the steroid treatment was discontinued at the patient's insistence. About a year later, the type 1 AIP relapsed, and steroid treatment was reinstituted. During tapering of the steroid dose, the patient contracted COVID-19.
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