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2.
Arq. bras. med. vet. zootec. (Online) ; 73(4): 791-798, Jul.-Aug. 2021. tab
Article in English | LILACS, VETINDEX | ID: biblio-1285265

ABSTRACT

The Nelore breed is the second largest bovine breed in the world and has actively participated in the expansion of new Brazilian agricultural frontiers. In this context, the purpose of this study was to determine the hematological and biochemical reference intervals of healthy Nelore matrices raised under an extensive regime without supplementation along southwest of Piauí state. Blood samples were collected from fifty-five multiparous female of the Nelore breed. Biochemical and hematological parameters were analyzed using a parametric statistical method with 95% CI of reference limits. The average values of red blood cells, hemoglobin as well as hematimetric indices showed reference ranges similar to reference standards. The hematocrit as well as granulocytes and agranulocytes presented alterations typical of animals raised in environments with higher temperatures. Mineral, enzymatic, protein and metabolic profiles were similar to other bovine breeds but with a narrower range of values. However, lower mean values were observed for levels of ionized calcium, total protein and urea. Nelore females present slightly different biochemical and hematological profiles from other breeds, which might result from the environmental and nutritional management applied and the natural deficiency of nitrogen, phosphorus and calcium in the region's pastures.(AU)


Nelore é a segunda maior raça bovina do mundo e tem participado ativamente da expansão das novas fronteiras agrícolas brasileiras. Nesse contexto, o objetivo do presente estudo foi determinar os intervalos de referência hematológicos e bioquímicos de matrizes Nelore criadas em regime extensivo sem suplementação, ao longo do sudoeste do estado do Piauí. Amostras de sangue foram coletadas de 55 fêmeas multíparas da raça Nelore. Os parâmetros bioquímicos e hematológicos foram analisados por método estatístico paramétrico com IC 95% para os limites de referência. Os valores médios de hemácias, hemoglobina e índices hematimétricos apresentaram intervalos de referência semelhantes aos padrões de referência. Tanto o hematócrito quanto os granulócitos e os agranulócitos apresentaram alterações típicas de animais criados em ambientes com temperaturas mais elevadas. Os perfis mineral, enzimático, proteico e metabólico foram semelhantes aos de outras raças bovinas, mas com uma faixa de valores mais estreita. No entanto, valores médios mais baixos foram observados para os níveis de cálcio ionizado, proteína total e ureia. Fêmeas Nelore apresentam perfis bioquímicos e hematológicos ligeiramente diferentes de outras raças, o que pode resultar dos manejos ambiental e nutricional aplicados e da deficiência natural de nitrogênio, fósforo e cálcio nas pastagens da região.(AU)


Subject(s)
Animals , Female , Cattle , Blood Cell Count/veterinary , Blood Urea Nitrogen , Blood Proteins/analysis , Calcium/blood , Granulocytes , Hematocrit/veterinary , Reference Values , Brazil , Serum , Agranulocytosis/veterinary
3.
Medicina (B.Aires) ; 80(6): 722-725, dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1250302

ABSTRACT

Resumen La agranulocitosis asociada al consumo de cocaína es un fenómeno vinculado a la presencia de levamisol, un agente antihelmíntico e inmunomodulador, usado como adulterante de la cocaína. Esta reacción puede presentarse con mayor frecuencia en personas con HLA B27. Además de la agranulocitosis, las personas que consumen cocaína adulterada con levamisol pueden desarrollar fiebre, lesiones en piel, artralgias y, menos frecuentemente, artritis y entesitis inflamatoria. Presentamos el caso de un paciente consumidor de cocaína, con genotipo HLA B27, que desarrolló agranulocitosis febril y artropatía reactiva. En sangre se detectó la presencia de ANCA p, ANCA atípico y MPO, y fueron excluidas otras causas de agranulocitosis. Fue tratado con corticoides y posteriormente metotrexato, terapia de deshabituación, con buena evolución.


Abstract Agranulocytosis associated with cocaine use is a phenomenon linked to the presence of levamisole, an anthelminthic and immunomodulating agent, used as an adulterant to cocaine. This reaction has been associated with the presence of HLA B27. In addition to agranulocytosis, people who use levamisole-adulterated cocaine may develop fever, skin lesions, arthralgias, and less frequently, inflammatory enthesitis and arthritis. We present the case of a cocaine-consuming patient with HLA B27 genotype, who developed febrile agranulocytosis and inflammatory arthropathy. The presence of p ANCA, atypical ANCA and MPO was detected in blood, and other causes of agranulocytosis were excluded. He was treated with corticosteroids and later methotrexate, therapy for addiction, with good evolution.


Subject(s)
Humans , Male , Adult , Cocaine , Cocaine-Related Disorders/complications , Agranulocytosis/chemically induced , Joint Diseases , HLA-B27 Antigen/genetics , Levamisole/adverse effects
4.
Rev. cuba. invest. bioméd ; 39(2): e498, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1126592

ABSTRACT

Se estudió una paciente de 33 años de edad con antecedentes patológicos de Bocio tiroideo difuso desde hace 8 años, que acude al cuerpo de guardia por presentar falta de aire, fiebre de 39-40 °C, dolor de garganta y palpitaciones hace alrededor de tres días. Al examen físico se le constató exoftalmos, mucosas hipocoloreadas y faringe purulenta y punteada de color blanquecina, artralgia y taquicardia. Referente a los exámenes complementarios presentó anemia, leucopenia y pancitopenia luego de haber consumido propiltiouracilo (50mg) por un período prolongado; por lo que se concluye como agranulocitosis como consecuencia de una reacción adversa al propiltiouracilo. Luego de ser tratada la paciente se recupera de su gravedad con el uso de factores estimulantes de colonias de granulocitos(AU)


A female 33-year-old patient with an 8-year history of diffuse thyroid goiter presents at the emergency service with shortness of breath, a 39-40ºC fever, a sore throat and palpitation of 3 days' evolution. Physical examination revealed exophthalmos, hypopigmented mucosas, a purulent pharynx dotted with whitish spots, arthralgia and tachycardia. Complementary tests found anemia, leukopenia and pancytopenia upon consumption of propylthiouracil (50 mg) for a long period. The diagnosis is agranulocytosis resulting from an adverse reaction to propylthiouracil. After being treated the patient recovered from her severe status with the use of granulocyte colony stimulating factors(AU)


Subject(s)
Humans , Female , Adult , Propylthiouracil/adverse effects , Agranulocytosis/complications , Goiter
5.
Rev. colomb. anestesiol ; 47(2): 81-83, Apr.-June 2019.
Article in English | LILACS, COLNAL | ID: biblio-1003820

ABSTRACT

Dipyrone (or metamizole) is an analgesic and antipyretic for oral or parenteral administration. Its action mechanism is directly related to the inhibition of the signaling of TRPA1 (Transient Receptor Potential Ankirin 1). The TRPA1 ion channel, located in the plasma membrane of a subpopulation of nociceptors, plays a major role in pain transmission.1-3 However, the clinical use of dipyrone is associated with various adverse effects such as agranulocytosis, aplastic anemia, anaphylaxis, toxic epidermal necrolysis, renal failure, upper gastrointestinal tract bleeding, induction of acute attacks of porphyria, among others.4-7 One study also reported an increased risk of leukemia in children born to mothers who took dipyrone during pregnancy.


La dipirona (o metamizol) es un analgésico y antipirético para administración oral o parenteral. Su mecanismo de acción está directamente relacionado con la inhibición de la señalización de TRPA1 (Transient Receptor Potential Ankirin 1). El canal de iones TRPA1, localizado en la membrana plasmática de una subpoblación de nocioceptores, tiene una función primordial en la transmisión del dolor.1­3 Sin embargo, el uso clínico de la dipirona se asocia a diversos efectos adversos como agranulocitosis, anemia aplástica, anafilaxia, necrolisis epidérmica tóxica, insuficiencia renal, sangrado de tracto gastrointestinal superior, inducción de ataques agudos de porfiria, entre otros.4­7 Un estudio reportó también un incremento en el riesgo de leucemia en niños nacidos de madres que consumieron dipirona durante el embarazo.


Subject(s)
Humans , Male , Female , Pregnancy , Dipyrone , Pain , Administration, Oral , Risk Factors , Agranulocytosis , Renal Insufficiency , Patient Safety , Analgesics
6.
Rev. Assoc. Med. Bras. (1992) ; 65(6): 755-760, June 2019. tab
Article in English | LILACS | ID: biblio-1013003

ABSTRACT

SUMMARY INTRODUCTION: Graves' disease (GD) is an autoimmune disorder characterized by hyperthyroidism. Antithyroid drugs (ATDs) are available as therapy. Agranulocytosis is a rare but potentially fatal complication of this therapy. In this study, we report agranulocytosis induced by propylthiouracil (PTU) in a patient with GD and the difficulties of clinical management. CASE: RNBA, male, 30 years old, with GD, treated with propylthiouracil (PTU). He progressed with pharyngotonsillitis. Then, PTU was suspended and antibiotic, filgrastim, propranolol, and prednisone were initiated. Due to the decompensation of hyperthyroidism, lithium carbonate, dexamethasone, and Lugol's solution were introduced. Total thyroidectomy (TT) was performed with satisfactory postoperative progression. DISCUSSION: We describe here the case of a young male patient with GD. For the treatment of hyperthyroidism, thioamides are effective options. Agranulocytosis induced by ATDs is a rare complication defined as the occurrence of a granulocyte count <500/mm3 after the use of ATDs. PTU was suspended, and filgrastim and antibiotics were prescribed. Radioiodine (RAI) or surgery are therapeutic alternatives. Due to problems with ATD use, a total thyroidectomy was proposed. The preoperative preparation was performed with beta-blocker, glucocorticoid, lithium carbonate, and Lugol solution. Cholestyramine is also an option for controlling hyperthyroidism. TT was performed without postoperative complications. CONCLUSION: Thionamide-induced agranulocytosis is a rare complication. With a contraindication to ATDs, RAI and surgery are definitive therapeutic options in GD. Beta-blockers, glucocorticoids, lithium carbonate, iodine, and cholestyramine may be an adjunctive therapy for hyperthyroidism.


RESUMO INTRODUÇÃO: A doença de Graves (DG) é uma doença autoimune caracterizada por hipertireoidismo. As drogas antitireoidianas (DAT) são opções terapêuticas disponíveis. A agranulocitose é uma complicação rara, potencialmente fatal desta terapia. Neste estudo, relatamos um caso de agranulocitose induzida por propiltiouracil (PTU) em paciente com DG e as dificuldades do manejo clínico. RELATO DE CASO: RNBA, sexo masculino, 30 anos, com DG, tratado com PTU. Evoluiu com faringoamigdalite, sendo o PTU suspenso e antibióticos, filgrastim, propranolol e prednisona, iniciados. Devido à descompensação do hipertireoidismo, iniciou carbonato de lítio (CL), dexametasona e a solução de Lugol. A tireoidectomia total (TT) foi realizada com boa evolução pós-operatória. DISCUSSÃO: Descrevemos caso de paciente jovem, sexo masculino, com DG. Para o tratamento do hipertireoidismo, as tionamidas são opções efetivas. A agranulocitose induzida por DATs é uma complicação rara, definida como a ocorrência de contagem de granulócitos <500/mm3 após uso de dats. PTU foi suspenso e foram prescritos filgrastim e antibiótico. O radioiodo (RAI) ou a cirurgia são alternativas terapêuticas. Devido a problemas com o uso de DAT, a TT foi proposta. A preparação pré-operatória foi realizada com betabloqueador, glicocorticoide, CL e solução de Lugol. A colestiramina também é uma opção para controlar o hipertireoidismo. A TT foi realizada sem complicações pós-operatórias. CONCLUSÃO: A agranulocitose induzida por drogas antitireoidianas é uma complicação rara. Com a contraindicação às DATs, RAI e cirurgia são opções terapêuticas definitivas para DG. Os betabloqueadores, glicocorticoides, CL, iodo e a colestiramina podem ser uma terapia adjuvante para o hipertireoidismo.


Subject(s)
Humans , Male , Adult , Propylthiouracil/adverse effects , Antithyroid Agents/adverse effects , Graves Disease/drug therapy , Agranulocytosis/chemically induced , Thyroid Function Tests , Thyroidectomy , Rare Diseases
7.
Article in Korean | WPRIM | ID: wpr-766487

ABSTRACT

Is it necessary to intake anthelmintics every year in Korea? To answer to this question, the recent nation-wide egg positive rate of the intestinal nematodes in Korea was presented. The anthelminthics which are purchasable without physician's prescription were also introduced with their pharmacological reaction and indication. The egg positive rate of Ascaris lumbricoides in 2012 was 0.025%. Those of Trichuris trichiura and Enterobius vermicularis were 0.27% and 0.004%, respectively. In 2018, purchasable anthelmintics without physician's prescription in Korea were albendazole and flubendazole only. Those two anthelmintics were derivatives of benzimidazole that may cause some side effects such as hepatitis, increase of hepatic enzymes, granulocytopenia, or pancytopenia. These anthelmintics showed excellent effect to ascariasis; while, they are not sufficient to treat trichuriaiss. For treatment of enterobiasis, repeated taking 3 times with 3 weeks interval and mass treatment of the family of egg positive person are required. In conclusion, it is not necessary to take anthelmintics every year without specific diagnosis because of negligible egg positive rate of intestinal nematodes and complicated therapeutic module for enterobiasis. There was no specific symptom of ascariasis or trchuriasis if worm burden is not high. The common symptoms of enterobiasis were pain or itching at the perianal area, sleep difficulty, or diarrhea. If intestinal nematode infection is suspected, stool examination or perianal swab should be done before prescribing anthelmintics.


Subject(s)
Agranulocytosis , Albendazole , Anthelmintics , Ascariasis , Ascaris lumbricoides , Diagnosis , Diarrhea , Enterobiasis , Enterobius , Hepatitis , Humans , Korea , Nematode Infections , Ovum , Pancytopenia , Prescriptions , Pruritus , Trichuris
8.
Article in Korean | WPRIM | ID: wpr-716012

ABSTRACT

Ecthyma gangrenosum (EG) is a rare skin manifestation which starts with a maculopapular eruption and followed by a necrotic ulcer covered with black eschar. EG usually occurs in immunosuppressed patients with Pseudomonas aeruginosa sepsis. We present a previously healthy 12-month-old girl with EG by P. aeruginosa and agranulocytosis due to influenza A and then rhinovirus infection, without bacteremia. It is important for allergists to culture wound and differentiate EG from other skin disorders including Tsutsugamushi disease and initiate appropriate empiric antipseudomonal antibiotic treatment, and to evaluate for possible immunodeficiency, even in a healthy child.


Subject(s)
Agranulocytosis , Bacteremia , Child , Ecthyma , Female , Humans , Infant , Influenza, Human , Pseudomonas aeruginosa , Rhinovirus , Scrub Typhus , Sepsis , Skin , Skin Manifestations , Ulcer , Wounds and Injuries
9.
Article in English | WPRIM | ID: wpr-718209

ABSTRACT

Autoimmune hemolytic anemia is a disease characterized with destruction of erythrocytes as a result of antibody produce against patient's own erythrocytes and anemia. Autoimmune hemolytic anemia can be roughly stratified into two groups according to serological features and secondary causes including drugs induced hemolytic anemia. Drugs induced autoimmune hemolytic anemia is very rare in pediatric patients. Even though hematological side effects such as leucopenia, agranulocytosis, eosinophilia, thrombocytopenic purpura and aplastic anemia might occur due to psychotropic drug use; to the best of our knowledge there is no autoimmune hemolytic anemia case due to quetiapine, an atypical antipsychotics, in literature. We hereby describe the first child case of autoimmune hemolytic anemia during quetiapine treatment.We also are pointing out that one should keep in mind serious hematological side effects with atypical antipsychotic drug use with this case report.


Subject(s)
Agranulocytosis , Anemia , Anemia, Aplastic , Anemia, Hemolytic , Anemia, Hemolytic, Autoimmune , Antipsychotic Agents , Child , Eosinophilia , Erythrocytes , Humans , Purpura, Thrombocytopenic , Quetiapine Fumarate
10.
Rev. colomb. anestesiol ; 46(4): 327-330, 2018. tab
Article in English | LILACS, COLNAL | ID: biblio-978215

ABSTRACT

Abstract Introduction: Dipyrone has been positioned in several countries as one of the first over-the-counter options for pain management. Its possible adverse effects are known worldwide; among them, agranulocytosis is the most lethal, with a mortality of approximately 10% and an associated risk of 1 per 1,000,000 patients. Clinical findings, interventions, and outcomes: A case of a patient who, after 23 days of using dipyrone for pain management, developed a progressive drop in leukocyte count. Other potential causes of the event were ruled out. After dipyrone discontinuation, leukocyte counts returned to their normal values. Conclusion: The probable diagnosis of granulocytopenia as a dipyrone-related adverse drug reaction was established. Although rare, dipyrone-related granulocytopenia, may occur in patients who use this medication for long periods.


Resumen Introducción: La dipirona se ha posicionado en varios países como una de las primeras opciones de venta libre al público para el manejo del dolor. Sus posibles efectos adversos son conocidos a nivel mundial; entre ellos, la agranulocitosis es la más letal con una mortalidad aproximada del 10% y un riesgo asociado de 1 por cada 1.000.000 pacientes. Hallazgos clínicos, intervención y resultados: Se presenta un caso de una paciente que luego de recibir 23 días seguidos dipirona para el manejo del dolor presentó disminución progresiva de los leucocitos documentados en el hemograma. Se descartaron otras posibles causas de dicho evento. Luego de suspender la administración de la dipirona los leucocitos volvieron a sus valores normales. Conclusión: Se estableció la sospecha de diagnóstico probable de granulocitopenia como reacción adversa medicamentosa por dipirona. La granulocitopenia por dipirona aunque poco frecuente, se puede presentar en pacientes que la reciben por largos periodos de tiempo.


Subject(s)
Humans , Female , Middle Aged , Dipyrone , Agranulocytosis , Drug-Related Side Effects and Adverse Reactions , Reference Values , Dipyrone/adverse effects , Leukocyte Count , Leukocytes
12.
Medisan ; 21(11)nov. 2017. ta, graf
Article in Spanish | LILACS | ID: biblio-894575

ABSTRACT

Se realizó un estudio descriptivo y transversal de 330 pacientes con cáncer, atendidos en el Hospital Oncológico Conrado Benítez de Santiago de Cuba, desde junio hasta diciembre del 2014, para determinar la presencia de neutropenias inducidas por quimioterapia. Presentaron esa afección 145 pacientes (44,0 por ciento). Predominaron el grupo etario de 41-60 años (51,0 por ciento), el sexo femenino (87,5 por ciento), el cáncer de mama (64,8 por ciento), el estadio clínico II (50,3 por ciento), los afectados con 2 episodios de neutropenia (62,1 por ciento), así como los grados leve (51,7 por ciento) y moderado (37,9 por ciento). Respondieron al tratamiento con ior® LeukoCIM 118 pacientes (81,4 por ciento). No se estableció asociación entre las diferentes combinaciones de citostáticos, el número de episodios y los grados de esa enfermedad. La disponibilidad del ior® LeukoCIM para tratar dicha afección facilitará su uso profiláctico y mejorará la calidad de vida de estos pacientes


A descriptive and cross-sectional study of 330 patients with cancer, assisted in Conrado Benítez Oncological Hospital in Santiago de Cuba, was carried out from June to December, 2014, to determine the presence of neutropenias induced by chemotherapy. This disorder was present in 145 patients (44.0 percent). There was a prevalence of the 41-60 age group (51.0 percent), female sex (87.5 percent), breast cancer (64.8 percent), clinical stage II (50.3 percent), those affected patients with 2 neutropenia episodes (62.1 percent), as well as light (51.7 percent) and moderate grades (37.9 percent). One hundred eighteen patients responded to the treatment with ior® LeukoCIM (81.4 percent). There was no association between the different combinations of cytostatics, number of episodes and grades of that disease. The availability of the ior® LeukoCIM to treat this disorder will facilitate its prophylactic use and will improve these patients life quality


Subject(s)
Humans , Male , Female , Agranulocytosis , Cytostatic Agents/adverse effects , Chemotherapy-Induced Febrile Neutropenia , Neoplasms , Secondary Care , Epidemiology, Descriptive , Cross-Sectional Studies , Retrospective Studies , Neutropenia
13.
Rev. med. Rosario ; 83(2): 75-78, mayo-ago. 2017.
Article in Spanish | LILACS | ID: biblio-973301

ABSTRACT

Los fármacos antitiroideos constituyen uno de los pilares del tratamiento del hipertiroidismo. En nuestro país solo se encuentra disponible el metimazol. Estas drogas han sido asociadas a múltiples reacciones adversas, la mayoría leves. Efectos adversos infrecuentes pero potencialmente letales como la agranulocitosis, hepatitis y el síndrome de artritis por antitiroideos, obligan a suspender el tratamiento. Comunicamos dos casos de complicaciones infrecuentes del tratamiento con metimazol.


Antithyroid drugs are one of the cornerstones in the management of hyperthyroidism. In our country, only methimazole is available. These drugs have been related to a variety of adverse reactions, most of them minor. Infrequent but potentially lethal side effects such as agranulocytosis, hepatitis and the antithyroid arthritis syndrome, demand drug cessation. We report two cases of infrequent complications of methimazole.


Subject(s)
Humans , Female , Adult , Antithyroid Agents , Antithyroid Agents/administration & dosage , Antithyroid Agents/adverse effects , Methimazole/administration & dosage , Methimazole/adverse effects , Agranulocytosis , Hyperthyroidism , Pharmaceutical Preparations
14.
Article in Korean | WPRIM | ID: wpr-139823

ABSTRACT

OBJECTIVES: Clozapine is an antipsychotic agent commonly prescribed in patients with treatment-resistant schizophrenia. A drawback of using clozapine is risk of hematologic side effects ranging from mild neutropenia to fatal agranulocytosis. In clinical settings, other atypical antipsychotic agents are frequently combined with clozapine because some treatment-resistant patients would not respond to clozapine alone. Unfortunately, other atypical antipsychotics may also cause hematologic side effects, and the combination therapy might aggravate the possible neutropenic side effects. The purpose of this study was to investigate the difference in the incidence of hematologic side effects between clozapine monotherapy and augmentation therapy. METHODS: We retrospectively reviewed the medical records of 114 patients who were diagnosed with schizophrenia and being prescribed with clozapine in a single university hospital. White blood cell count (WBC) and absolute neutrophil count (ANC) were identified every 1 month in clozapine monotherapy group and clozapine-atypical antipsychotics augmentation therapy group. RESULTS: Compared with clozapine monotherapy group, augmentation therapy group showed no significant differences in WBC and ANC for the first 6 months of combination. Amisulpride augmentation showed temporary increases in WBC and ANC, especially compared with paliperidone augmentation. CONCLUSION: Augmentation of amisulpride to clozapine might be associated with temporary increases in WBC and ANC during the first 3 months of combination. Further investigations should be carried out to clarify the clinical significance of our findings.


Subject(s)
Agranulocytosis , Antipsychotic Agents , Clozapine , Follow-Up Studies , Humans , Incidence , Leukocyte Count , Leukocytes , Medical Records , Neutropenia , Neutrophils , Paliperidone Palmitate , Retrospective Studies , Schizophrenia
15.
Article in Korean | WPRIM | ID: wpr-139822

ABSTRACT

OBJECTIVES: Clozapine is an antipsychotic agent commonly prescribed in patients with treatment-resistant schizophrenia. A drawback of using clozapine is risk of hematologic side effects ranging from mild neutropenia to fatal agranulocytosis. In clinical settings, other atypical antipsychotic agents are frequently combined with clozapine because some treatment-resistant patients would not respond to clozapine alone. Unfortunately, other atypical antipsychotics may also cause hematologic side effects, and the combination therapy might aggravate the possible neutropenic side effects. The purpose of this study was to investigate the difference in the incidence of hematologic side effects between clozapine monotherapy and augmentation therapy. METHODS: We retrospectively reviewed the medical records of 114 patients who were diagnosed with schizophrenia and being prescribed with clozapine in a single university hospital. White blood cell count (WBC) and absolute neutrophil count (ANC) were identified every 1 month in clozapine monotherapy group and clozapine-atypical antipsychotics augmentation therapy group. RESULTS: Compared with clozapine monotherapy group, augmentation therapy group showed no significant differences in WBC and ANC for the first 6 months of combination. Amisulpride augmentation showed temporary increases in WBC and ANC, especially compared with paliperidone augmentation. CONCLUSION: Augmentation of amisulpride to clozapine might be associated with temporary increases in WBC and ANC during the first 3 months of combination. Further investigations should be carried out to clarify the clinical significance of our findings.


Subject(s)
Agranulocytosis , Antipsychotic Agents , Clozapine , Follow-Up Studies , Humans , Incidence , Leukocyte Count , Leukocytes , Medical Records , Neutropenia , Neutrophils , Paliperidone Palmitate , Retrospective Studies , Schizophrenia
16.
Article in English | WPRIM | ID: wpr-159406

ABSTRACT

In epithelial ovarian cancer (EOC), intraperitoneal (IP) administration of chemotherapy is an effective first-line treatment and may improve outcomes, compared with intravenous (IV) chemotherapy. We used Kaplan-Meier survival analysis to compare long-term survival between propensity score-matched patients with advanced EOC receiving IP (n = 34) vs. IV (n = 68) chemotherapy. Additionally, clinical features associated with carboplatin-based (n = 21) and cisplatin-based (n = 16) IP chemotherapy were analyzed and compared with those associated with IV chemotherapy. The IP and IV chemotherapy groups had a median follow-up duration of 67 (range, 3–131) and 62 (range, 0–126) months, respectively, with no significant difference in progression-free survival (PFS) (P = 0.735) and overall survival (OS) (P = 0.776). A significantly higher proportion of patients in the IV (91.2%) than in the IP (67.6%) chemotherapy group (P = 0.004) received ≥ 6 cycles. However, the frequency of toxic events (anemia, granulocytopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) was significantly higher in the IP than in the IV group. Within the IP group, no significant differences were observed in PFS (P = 0.533) and OS (P = 0.210) between the cisplatin-based and carboplatin-based chemotherapy subgroups. The 10-year OS was 28.6% and 49.2% in carboplatin-based and cisplatin-based IP chemotherapy groups, respectively. Toxic events (granulocytopenia, leukopenia, nausea/vomiting, abdominal pain, hepatotoxicity, neuromuscular effects) were significantly more common in the cisplatin-based subgroup. In patients with EOC, cisplatin-based IP chemotherapy may be an acceptable alternative to IV chemotherapy regarding long-term survival, but toxicity must be addressed.


Subject(s)
Abdominal Pain , Agranulocytosis , Carboplatin , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Humans , Leukopenia , Ovarian Neoplasms , Survival Analysis
17.
Article in English | WPRIM | ID: wpr-58951

ABSTRACT

Antipsychotic-induced agranulocytosis is a significant side effect that is known to occur with most of the antipsychotic medications. It usually resolves once the medications are stopped and patients are able to be switched over to another antipsychotic medication. Lurasidone has not been reported to cause leukopenia and neutropenia. This case report is of a patient with a past history of risperidone induced-aganulocytosis developing dose related leukopenia and neutropenia with lurasidone.


Subject(s)
Agranulocytosis , Antipsychotic Agents , Humans , Leukopenia , Lurasidone Hydrochloride , Neutropenia , Risperidone
18.
Rev. chil. neuro-psiquiatr ; 55(2): 77-84, 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-899784

ABSTRACT

Introduction: Agranulocytosis is one of the most serious adverse effects of clozapine. The Latin American literature is currently scarce on the subject. Objective: To describe the occurrence of agranulocytosis or leukopenia secondary to clozapine and its associated factors in a sample of Chilean patients between the years 2011-2016. Materials and Methods: An observational, retrospective type of study was designed base on virtual information from the National Pharmacovigilance Registry and definition of alarm levels according to the Technical Standard of clozapine, later performing statistical analysis. Results: total n 60 patients, 8 patients with some alarm event; Alarm 1:5; Alarm II: 1; Alarm III: 2. Alarms were distributed between week 1 and week 242. The incidence was higher between weeks 0 and 12 (1.26%). Until week 18,53% of alarms I and 100% of alarms III occurred, alarm II occurred in month 10. Discussion: When comparing patients with and without alarm, significant differences were found in the basal count of leukocytes and neutrophils, with no differences in age and sex. Patients who presented alarms and/or lower baseline leukocyte or neutrophil counts could eventually benefit from a longer weekly follow-up. Conclusion: This study constitutes the first step towards exploring the adverse effects profile of clozapine in Chilean patients.


Introducción: La agranulocitosis es uno de los efectos adversos más graves de la clozapina. Existe escasa literatura latinoamericana al respecto. Objetivo: Describir la ocurrencia de agranulocitosis o leucopenia secundaria a clozapina y sus factores asociados en una muestra de pacientes chilenos entre los años 2011-2016. Materiales y Métodos: Se diseñó un estudio de tipo observacional, retrospectivo con información virtual del Registro Nacional de Farmacovigilancia y definición de niveles de alarma según Norma Técnica de clozapina, realizando posteriormente análisis estadístico. Resultados: En total 60 pacientes, 8 pacientes con algún evento de alarma; Alarma 1:5; Alarma II: 1; Alarma III: 2. Las alarmas se distribuyeron entre la semana 1 y la 242. La incidencia fue mayor entre las semanas 0 y 12 (1,26%). Hasta la semana 18 habían ocurrido el 53% de alarmas I y 100% de alarmas III, la alarma II ocurrió en el mes 10. Discusión: Al comparar a los pacientes con y sin alarma, se encontraron diferencias significativas en el conteo basal de leucocitos y neutrófilos, sin diferencias en edad y sexo. Aquellos pacientes que han presentado alarmas y/o menores conteos basales de leucocitos o neutrófilos, eventualmente, podrían beneficiarse de un seguimiento semanal más prolongado. Conclusión: Este estudio corresponde a un primer paso hacia explorar el perfil de efectos adversos de clozapina en pacientes chilenos.


Subject(s)
Humans , Male , Female , Patients , Clozapine , Agranulocytosis , Chile , Retrospective Studies , Observational Study
19.
Article in Chinese | WPRIM | ID: wpr-360078

ABSTRACT

<p><b>OBJECTIVE</b>To explore the clinical efficacy and toxicity of CLAT protocol (cladribine, cytarabine and topotecan) for treating patients with refractory acute myeloid leukemia (R-AML).</p><p><b>METHODS</b>A total of 18 patients with R-AML (median age 37 years, range 18 to 58 years; male n = 16, female n = 2) were treated with CLAT protocol, which consisted of cladribine 5 mg/m(2)/d, i.v. on days 1-5, cytarabine 1.5 g/m(2)/d, i.v. on days 1-5, topotecan 1.25 mg/m(2)/d, i.v. on days 1-5 and G-CSF 300 µg/d subcutaneous injection on day 6 until neutrophile granulocyte recovery.</p><p><b>RESULTS</b>Out of 18 patients 2 died of severe infection before the assessment. Among 16 evaluated patients, 10 (55.6%) achieved complete remission (CR), and 2 (11.1%) achieved partial remission (PR), the overall response rate was 66.7%, the rest 4 patients did not respond (NR). The median overall survival time and DFS for the CR patients was 9.5 months (95%CI: 6.7-16.64) and 9.5 months (95%CI: 6.1-16.7) respectively. The 1 year OS and DFS rates were 45% and 46.9%, respectively. All patients developed grade 4 of granulocytopenia and thrombocytopenia, the median duration was 13 (range 2 to 21) days and 12 days (range 2 to 21), respectively, all patients developed infection, 2 patients died of severe infection. The most common non-hematological side effects included nausea, vomiting, diarrhoea, rash, aminotransferase or bilirubin elevation and were grade 1 to 2.</p><p><b>CONCLUSION</b>The CLAT protocol seems to have promising for the treatment of refractory AML patients, and patients well tolerated. This CLAT protocol offers an alternative treatment for R-AML patients who received severe intensive treatment, especially with anthracycline-containing chemotherapy.</p>


Subject(s)
Adolescent , Adult , Agranulocytosis , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Cladribine , Therapeutic Uses , Cytarabine , Therapeutic Uses , Female , Granulocyte Colony-Stimulating Factor , Therapeutic Uses , Humans , Leukemia, Myeloid, Acute , Drug Therapy , Male , Middle Aged , Remission Induction , Thrombocytopenia , Topotecan , Therapeutic Uses , Young Adult
20.
Article in Korean | WPRIM | ID: wpr-76120

ABSTRACT

Fungi of Aspergillus genus are widely distributed in nature, particularly in the soil and in decomposing vegetation. They are frequent opportunistic pathogens in immunocompromised patients, second only to Candida. The most common agent is A. fumigatus, followed by A. flavus, mainly in invasive disease in immunocompromised patients, and in nasal or paranasal sinus lesions. Cutaneous aspergillosis is a rare condition. There are several factors that predispose to Aspergillus infection: the most frequent are granulocytopenia, haematological disorders, diabetes, the neonatal period, local tissue injury, and any primary or acquired diseases that cause immunosuppression. A 25-year-old male was referred to department of dermatology for his skin lesions on the both axillary areas. The skin lesions showed localized erythematous to brownish scaly patches on the both axillary areas. A KOH mount fungal smear showed fungal hyphae, and Aspergillus species was grown in culture. rDNA ITS sequencing result was also consistent with A. flavus. He was treated with itraconazole 200 mg daily for 4 weeks, and showed a good response. This case is thought to be peculiar in that cutaneous aspergillosis is detected in an immunocompetent host.


Subject(s)
Adult , Agranulocytosis , Aspergillosis , Aspergillus flavus , Aspergillus , Candida , Dermatology , DNA, Ribosomal , Fungi , Humans , Hyphae , Immunocompromised Host , Immunosuppression Therapy , Itraconazole , Male , Skin , Soil
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