ABSTRACT
BACKGROUND: Splenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereas its clinical significance in wAIHA remains unclear. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion (SC). METHODS: We included patients with wAIHA treated in a Mexican tertiary hospital between January 1992 and December 2015. All patients received steroids as first-line treatment and splenectomy as second-line treatment. RESULTS: Among the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosed as SMM and SC, respectively. No differences were found in clinical characteristics between two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L, P=0.02) and higher presence of anti-dsDNA antibodies (40% vs. 4.7%, P=0.01) than SC patients. Although the complete response (CR) rate with first-line treatment was lower in SMM patients (13.3% vs. 47.6%; P=0.04), post-splenectomy median disease-free-survival (DFS) was longer (16.2 mo vs. 5.1 mo; P=0.19). Univariate/multivariate analysis showed that achieving CR during first-line treatment (OR 0.3, 95% CI: 0.03–0.94, P=0.03) and higher platelet count (OR 0.99, 95% CI: 0.98–0.99, P=0.03) were protective factors for SMM; and anti-dsDNA titer higher than 9.6 IU/dL was a risk factor for SMM (OR 2.76, 95% CI: 1.48–5.14, P < 0.001). CONCLUSION: The wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findings and their association with rheumatologic profile.
Subject(s)
Humans , Anemia, Hemolytic, Autoimmune , Antibodies , Hematopoiesis, Extramedullary , Platelet Count , Primary Myelofibrosis , Protective Factors , Retrospective Studies , Risk Factors , Spleen , Splenectomy , Steroids , Tertiary Care CentersABSTRACT
La frecuencia elevada de cisticersosis en paises en desarrollo y sus efectos patologicos y economicos senalan la necesidad de contar con una prueba satisfactoria para diagnosticar esta enfermedad. En el Hospital Central Ignacio Morones Prieto de San Luis Potosi, SLP, Mexico, se realizo un estudio en el que se comparo la sensibilidad del ensayo inmunosorbente enzima conjugada (ELISA) con la del metodo de hermaglutinacion indirecta (HI), para diagnosticar la cisticercosis. Por medio de ambos metodos se analizaron muestras de liquido cefalorraquideo y de suero de 120 pacientes neurologicos que se dividieron en dos grupos control y un grupo de 17 casos de cisticercosis cerebral confirmada. Las muestras de los grupos control resultaron negativas con ambos procedimientos, pero en el grupo de enfermos de cisticercosis con el metodo de HI se obtuvo 29% de resultados falsos negativos, en tanto que con ELISA no se obtuvo ninguno.Se concluye que el metodo ELISA es mas sensible que el de HI puesto que con el no se lograron resultados falsos negativos ni positivos sin embargo, en vista del pequeno numero de casos investigados no es posible llegar a una conclusion definitiva