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1.
Rev. cuba. med. trop ; 73(1): e528, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280335

ABSTRACT

Introducción: La histoplasmosis es una micosis causada por Histoplasma capsulatum. Este hongo se encuentra en las excretas de algunos animales (murciélagos y aves) y su reservorio es el suelo. Es una enfermedad endémica en el continente americano. La inhalación de esporas causa infección pulmonar primaria que puede diseminarse. Objetivo: Describir un caso de histoplasmosis bucal en un paciente seronegativo al virus de inmunodeficiencia humana. Caso clínico: Paciente diabético, fumador y alcohólico con cuadro febril de varios meses acompañado de manifestaciones respiratorias. Además, se constataron úlceras en encías y lengua, lesiones nodulares en mucosas del carrillo, fondo del surco vestibular y reborde alveolar. Se informó anemia, leucopenia y aumento de la velocidad de sedimentación globular. El diagnóstico se confirmó mediante citología e histopatología. La terapéutica empleada fue itraconazol 200 mg tres veces al día, luego 200 mg dos veces al día por dos meses y una tableta diaria hasta seis meses después del segundo mes. El paciente se encuentra asintomático y las lesiones bucales desaparecieron. Conclusiones: La histoplasmosis se diagnostica fundamentalmente por la epidemiología, la clínica y el cultivo. Los estudios citopatológicos e histopatológicos de la úlcera confirman el diagnóstico. Este caso representa una forma no habitual de presentación de la enfermedad, que aunque no se sospecha usualmente, puede ocurrir. Este trabajo es una alerta a los estomatólogos, maxilofaciales y a todo aquel personal de la salud que asiste a pacientes con manifestaciones sistémicas(AU)


Introduction: Histoplasmosis is a mycosis caused by Histoplasma capsulatum. This fungus is found in the feces of some animals (bats and birds) and its reservoir is the soil. Histoplasmosis is an endemic disease in the American continent. Inhalation of spores causes primary pulmonary infection, which may in turn be disseminated. Objective: Describe a case of oral histoplasmosis in a patient seronegative to the human immunodeficiency virus. Clinical case: A case is presented of a diabetic, smoker and alcoholic patient with fever of several months' evolution and respiratory manifestations. Examination revealed ulcers in the patient's gums and tongue, as well as nodular lesions in the mouth mucosa, the bottom of the vestibular sulcus and the alveolar ridge. Laboratory testing found anemia, leucopenia and an increased globular sedimentation rate. The diagnosis was confirmed by cytology and histopathology. The treatment indicated was 200 mg itraconazole three times a day and then 200 mg twice a day for two months, and a daily tablet for six months after the second month. The patient is now asymptomatic and the oral lesions have disappeared. Conclusions: Histoplasmosis is mainly diagnosed by epidemiological testing, clinical examination and culture. Cytopathologic and histopathological analysis of the ulcer confirm the diagnosis. The case illustrates an infrequent form of presentation of the disease, not usually suspected but possible. The study is a warning to dentists, maxillofacial specialists and all the health personnel caring for patients with systemic manifestations(AU)


Subject(s)
Humans , Male , Ulcer , Itraconazole , Alcoholics , Smokers , Histoplasmosis , Leukopenia , Mouth Mucosa
2.
Article in Chinese | WPRIM | ID: wpr-880177

ABSTRACT

OBJECTIVE@#To investigate the therapeutic effect of spleen low molecular weight extracts on epileptics hydrochloride-induced leukopenia in mice and explore its mechanism.@*METHODS@#The model of leukopenia in mice was established by the injection of epirubicin hydrochloride (10 mg/kg). After the injection of chemotherapeutic drugs, leukocytopenia mice were treated with different doses of spleen low molecular weight extract, Ganoderma oral solution and recombinant granulocyte colony stimulating factor (rhG-CSF). The general survival status indicators such as body weight, coat color and athletic ability of mice in each group were recorded; the tail vein blood of mice in each group was collected and the white blood cell count in them was calculated; bone marrow of mice was taken and bone marrow smears were observed.@*RESULTS@#In the model group, the weight of the mice gradually decreased in the later period, their coat became dark and rough, and the ability to exercise decreased, while the mice in the treatment groups showed different degrees of improvement in their survival status except for the mice treated by rhG-CSF. There was no significant fluctuation in the white blood cell count of the blank control mice. After injection of epirubicin, the white blood cell count of peripheral blood in the model mice and treated mice were decreased. The white blood cell count was lower in the mice treated with high-dose low molecular weight extract and rhG-CSF than that in other experimental groups. Bone marrow smear showed that the proportion of bone marrow nucleated cells in the mice treated with the low molecular weight extract of the spleen was significantly higher than that of model mice (P<0.05).@*CONCLUSION@#The low molecular weight spleen extracts can significantly improve the hematopoietic state of mouse bone marrow, promote the proliferation of inhibited bone marrow cells, and thus has the effect of treating leukopenia in mice.


Subject(s)
Animals , Epirubicin , Granulocyte Colony-Stimulating Factor , Leukocyte Count , Leukopenia/drug therapy , Mice , Molecular Weight , Plant Extracts , Recombinant Proteins , Spleen
3.
Pesqui. vet. bras ; 41: e06575, 2021. tab
Article in English | LILACS, VETINDEX | ID: biblio-1250486

ABSTRACT

This study aimed to report the hematological and biochemical changes caused by conventional and metronomic chemotherapies, using vincristine sulfate to treat canine Transmissible Venereal Tumor (TVT). Twelve dogs were selected, six of them for the group receiving conventional chemotherapy (G1), and six dogs for the group receiving metronomic chemotherapy (G2). The G1 group received vincristine sulfate once a week at the dose of 0.75mg/m² until the tumor had disappeared with treatment, and the G2 group was treated with vincristine sulfate three times a week at the dose of 0.25mg/m2 until the tumor had disappeared. Before and after chemotherapy treatment, hematological and biochemical blood tests were performed to evaluate the main alterations caused by both chemotherapeutic models. Dogs undergoing conventional chemotherapy had significant leukocyte changes (p<0.05), causing neutropenia and leukopenia. In dogs undergoing metronomic chemotherapy, leukocytes remained within the reference range. Half of the dogs in group G1 had normochromic, normocytic anemia. The only biochemical alteration observed was the increase of urea in group G2. Thus, metronomic chemotherapy for the treatment of TVT with vincristine sulfate proved to be an excellent method for treatment, with fewer adverse effects, especially in maintaining the leukogram of dogs within normal range and reducing the number of anemia in animals during treatment.(AU)


Esta pesquisa teve como objetivo relatar as alterações hematológicas e bioquímicas causadas pelo tratamento quimioterápico convencional e pela quimioterapia metronômica, utilizando-se sulfato de vincristina para o tratamento do tumor venéreo transmissível canino(TVTC). Foram selecionados 12 cães, sendo seis para o grupo que recebeu quimioterapia convencional (G1) e seis cães para o grupo que recebeu quimioterapia metronômica (G2). O grupo G1 recebeu sulfato de vincristina, uma vez por semana, na dose de 0,75mg/m2, até o desaparecimento do tumor e o grupo G2 foi tratado com sulfato de vincristina, três vezes por semana, na dose de 0,25mg/m2, até o desaparecimento do tumor. Antes e após o tratamento quimioterápico foram realizados exames hematológicos e bioquímicos sanguíneos para avaliação das principais alterações causadas pelos dois modelos quimioterápicos. Os cães submetidos à quimioterapia convencional tiveram alterações leucocitárias significativas (p<0,05), causando uma leucopenia por neutropenia enquanto nos cães, submetidos à quimioterapia metronômica, os leucócitos mantiveram-se dentro do intervalo de referência. A metade dos cães do grupo G1 tiveram uma anemia do tipo normocítica normocrômica. A única alteração bioquímica observada foi o aumento da ureia no grupo G2. Desta forma, a quimioterapia metronômica para o tratamento do TVT com sulfato de vincristina, demonstrou ser um excelente método para a cura do animal, com menores reduções de efeitos adversos, sobretudo, na manutenção do leucograma dos cães e na redução de animais com anemia.(AU)


Subject(s)
Animals , Dogs , Venereal Tumors, Veterinary , Vincristine/analogs & derivatives , Biochemistry/methods , Hematologic Tests/veterinary , Anemia , Leukopenia , Neoplasms , Urea , Dogs/blood , Drug Therapy
4.
Arq. bras. med. vet. zootec. (Online) ; 72(6): 2127-2134, Nov.-Dec. 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1142324

ABSTRACT

Canine parvovirosis is a high mortality disease with acute clinical picture. However, there are few available resources to help stablish prognosis accurately. This study aimed to determine the prognostic threshold values for vital and hematological parameters of dogs naturally infected by the Carnivore protoparvovirus 1 (CPV). A retrospective study of 103 canine parvovirosis cases was carried out. Twenty seven percent of these (28/103) died, 96% (27/28) of which within the first four days of hospitalization. Deceased animals had significantly higher median values for heart (HR) and respiratory (f) rates, as well as significantly lower systolic blood pressure (SBP) than survivors. Severely leukopenic animals (<1,000 cells/µL), had a significantly higher mortality rate (68%, n=13) compared to that of other patients (P<0.0007). Animals with at least two of the following findings: severe hypotension (SBP< 90mmHg), tachycardia (HR > 150 bpm) and leukopenia, represented 34% (34/101) of the cases and had a survival rate of 29% (10/34), while animals with at most one of these parameters represented 66% (67/101) and had a survival rate of 94% (63/67). The presence of two or three abnormal parameters was significantly related to the higher death risk among dogs with parvovirosis (P<0.0001).(AU)


A parvovirose canina é uma doença de alta mortalidade e de quadro clínico agudo. No entanto, existem poucos recursos para se estabelecer prognóstico de maneira precisa. Este estudo objetivou analisar os valores prognósticos de parâmetros físicos e hematológicos de cães naturalmente infectados pelo Carnivore protoparvovirus 1 (CPV). Um estudo retrospectivo de 103 casos de parvovirose canina foi realizado. Desses, 27% dos animais (28/103) foram a óbito, sendo 96% (27/28) com ocorrência nos primeiros quatro dias de internamento. Os cães que foram a óbito apresentaram medianas das frequências cardíaca (FC) e respiratória (f) significativamente maiores e pressão arterial sistólica (PAS) consideravelmente menor que a dos sobreviventes. Entre os animais mais intensamente leucopênicos (<1.000 células/(L), a taxa de mortalidade (68%, n=13) foi expressivamente maior que a dos demais pacientes (P<0,0007). Os animais com hipotensão grave (PAS<90mmHg), taquicardia (FC>150bpm) e leucopenia intensa (leucometria<1.000 células/µL), ou duas dessas alterações clínicas, representaram 34% (34/101) dos casos e tiveram taxa de sobrevida de 29% (10/34), enquanto os animais com, no máximo, um desses parâmetros alterados representaram 66% (67/101) dos animais, com taxa de sobrevida de 94% (63/67). A presença de dois ou três parâmetros alterados esteve significativamente relacionada ao maior risco de óbito de cães com parvovirose (P<0,0001).(AU)


Subject(s)
Animals , Dogs , Parvovirus, Canine/isolation & purification , Parvoviridae Infections/complications , Parvoviridae Infections/epidemiology , Tachycardia/veterinary , Retrospective Studies , Hypotension/veterinary , Leukopenia/veterinary
5.
Rev. bras. anal. clin ; 52(2): 131-137, 20200630.
Article in Portuguese | LILACS | ID: biblio-1146823

ABSTRACT

A COVID-19 se manifesta principalmente como uma infecção do trato respiratório. Entretanto, uma enorme quantidade de estudos mostra características de uma enfermidade sistêmica com repercussões nos sistemas cardiovascular, respiratório, gastro­intestinal, neurológico, hematopoiético e imunológico. Os estudos realizados em vários centros de pesquisa na China, Europa e nos Estados Unidos indicam que os resultados laboratoriais podem fornecer à equipe clínica muitos marcadores prognósticos de grande utilidade. O impacto no sistema hematopoiético e na hemostasia é evidenciado por alterações importantes na quantidade de linfócitos, granulócitos e plaquetas além de alterações no processo de coagulação. Estes parâmetros podem ser monitorados e têm efeito prognóstico na evolução da doença podendo ajudar a identificar pacientes que necessitem de cuidados intensivos. Em resumo, a COVID-19 apresenta alterações importantes do sistema hematopoiético estando frequentemente associada a um estado de hipercoagulabilidade. A avaliação cuidadosa dos índices laboratoriais no início da doença e durante a evolução podem ajudar o corpo clínico a formular uma abordagem de tratamento adaptada à situação além de permitir atenção especial àqueles pacientes que apresentam maior necessidade.


COVID-19 manifests itself mainly as an infection of the respiratory tract. However, a huge number of studies show characteristics of a systemic disease with repercussions on the cardiovascular, respiratory, gastrointestinal, neurological, hematopoietic and immunological systems. Studies carried out in various research centers in China, Europe and the United States indicate that laboratory results can provide the clinical team with many useful prognostic markers. The impact on the hematopoietic system and hemostasis is evidenced by important changes in the amount of lymphocytes, granulocytes and platelets, in addition to changes in the coagulation process. These parameters can be monitored and have a prognostic effect on the evolution of the disease and can help to identify patients who need intensive care. In summary, COVID-19 presents important changes in the hematopoietic system and is frequently associated with a state of hypercoagulability. Careful assessment of laboratory indexes at the onset of the disease and during evolution can help the clinical staff to formulate a treatment approach adapted to the situation, in addition to allowing special attention to those most severe patients.


Subject(s)
Thrombocytopenia , Blood Cell Count , Blood Coagulation , Coronavirus Infections , Coronavirus , Severe Acute Respiratory Syndrome , Disseminated Intravascular Coagulation , Betacoronavirus , Leukopenia , Neutrophils
6.
Rev. méd. hondur ; 88(1): 38-42, ene.- jun. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1128552

ABSTRACT

Antecedentes: La enfermedad de Gaucher es causada por la acumulación del glicolípido glucosilceramidasa en el sistema macrofagocítico debido a la deficiencia de la enzima glucocerebrosidasa. Se han descrito tres formas clínicas de la enfermedad. La prevalencia mundial es de 1 caso en 40,000-100,000 nacimientos, aunque en poblaciones de ascendencia judío askenazi puede ser tan alta como 1 en 850 individuos. El diagnóstico definitivo se obtiene a través de observación directa de células Gaucher en médula ósea y la confirmación diagnóstica de las mutaciones en el cromosoma 1q21.31. Descripción del Caso: Femenina de 30 años con historia de 4 meses de hepatoesplenomegalia, leucopenia, neutropenia y trombocitopenia. Células de Gaucher se observaron en biopsia de médula ósea. Se confirmaron las variantes heterocigotas en los Exones 4 y 10 del Cromosoma 1q2. La paciente fue tratada con 5 mg de ácido fólico y multivitaminas. Es candidata para Terapia de Reemplazo de la Enzima con imiglucerasa, sin embargo, éste no está disponible en Honduras por su alto costo. Paciente continúa en seguimiento 5 años después del diagnóstico. Conclusión: La incidencia en Honduras es desconocida. Otros casos podrían permanecer sin ser diagnosticados debido a la complejidad del diagnóstico en el primer nivel de atención. Las enfermedades metabólicas son un reto para el sistema de salud debido al acceso limitado a la atención médica de calidad y a la escasez de médicos especialistas capacitados. Una de las fortalezas de este caso es el estudio laboratorial completo que incluye confirmación genética de la enfermedad...(AU)


Subject(s)
Humans , Female , Adult , Gaucher Disease/diagnosis , Metabolic Diseases , Thrombocytopenia , Leukopenia/complications
7.
Journal of Breast Cancer ; : 100-106, 2020.
Article in English | WPRIM | ID: wpr-811192

ABSTRACT

Palbociclib, in conjunction with endocrine therapy, has been approved for the treatment of patients with advanced breast cancer. The common hematological toxicities associated with palbociclib are leukopenia and neutropenia. However, hematological malignancies have not been reported for palbociclib treatment. Here, for the first time, we present a case of acute lymphoblastic leukemia that was diagnosed in a patient undergoing treatment with letrozole and palbociclib for metastatic breast cancer. This case emphasizes the need for long term follow up of patients treated with palbociclib.


Subject(s)
Breast Neoplasms , Follow-Up Studies , Hematologic Neoplasms , Humans , Leukopenia , Neutropenia , Precursor Cell Lymphoblastic Leukemia-Lymphoma
9.
Oncol. (Guayaquil) ; 29(3): 189-198, 31 de diciembre del 2019.
Article in Spanish | LILACS | ID: biblio-1140818

ABSTRACT

Introducción: La enfermedad de células falciformes es una condición heredada en la quese produce una hemoglobina anómala que desfavorece a la oxigenación tisular, crisis vaso-oclusivas y reacciones hemolíticas. Los pacientes con esta enfermedad presentan una activación anómala de la vía del complemento llevándolos al aumento en frecuencia de infecciones y enfermedades autoinmunes. Presentamos un caso de asociación de una enfermedad autoinmune en un paciente con enfermedad de células falciforme. Caso clínico: Niño de 10 años con Anemia drepanocítica (2009) con esplenectomía y crisis veno-oclusivas recurrentes, fue sometido a trasplante Alogénicoen abril del 2019fuera de la institución con donante isogrupo O+ no emparentado (10/10). Tratado con: Fludarabina ­Busulfan, Timoglobulina+ y Metotexate. Desarrolló Bicitopenia autoinmune y síndrome febril al día +165 post TPH. Glóbulos blancos: 360 uL, neutrófilos: 14 %, hemoglobina: 7.90 g/dL, plaquetas: 25000 uL, ferritina: 4695 ng/ml, IgG total: 9.88 gr/l, LDH: 190 UI/l. Proteína C reactiva: 2.79 mg/dL, Procalcitonina 0.13 ng/mL. Evolución: posterior a descartar infección viral, se completó un tratamiento antibiótico de amplio espectro y se realizó la suspensión del tratamiento inmunosupresor por sospecha de toxicidad, sin respuesta. Se realizó un estudio medular por citometría de flujo determinando una disminución de la línea linfoide B, y se concluye Citopenia Autoinmune como complicación inmunológica del trasplante. Desenlace: recibióterapia transfusional (plaquetoféresis + glóbulos rojos concentrados). Se utilizó metilprednisolona IV por 3 días y prednisona 30 mg por 14 días con reducción posterior gradual para inicio de Rituximab y ciclosporina. Se completó el tratamiento con Imnunoglobulina 6g IV por 5 días. Al alta glóbulos blancos: 5080 uL, neutrófilos: 67%, hemoglobina: 9.20 g/dL, plaquetas: 20000 uL, después de 18 días de ingreso hospitalario. Conclusión: Los resultados con el tratamiento en este caso sugieren que puede serrazonable considerar las citopeniasautoinmunes como una manifestación hematológica diagnóstica de la EICH crónica. Alternativamente, es posible que el tratamiento de citopenia inmune con esteroides, Rituximab y otros inmunosupresores


Introduction: Sickle cell disease is an inherited condition in which an abnormal hemoglobin is produced that impairs tissue oxygenation, vaso-occlusive crises and hemolytic reactions. Patients with this disease present an abnormal activation of the complement pathway, leading to an increase in the frequency of infections and autoimmune diseases. We present a case of association of an autoimmune disease in a patient with sickle cell disease. Clinical case:10-year-old boy with sickle cell anemia (2009) with splenectomy and recurrent veno-occlusive crisis, underwent Allogeneic transplantation in April 2019 outside the institution with an unrelated isogroup O + donor (10/10). Treated with: Fludarabine -Busulfan, Thymoglobulin + and Metotexate. He developed autoimmune bicytopenia and febrile syndrome at +165 day post HSCT. White blood cells: 360 uL, neutrophils: 14%, hemoglobin: 7.90 g / dL, platelets: 25,000 uL, ferritin: 4695 ng / ml, total IgG: 9.88 gr / l, LDH: 190 IU/l. C-reactive protein: 2.79 mg/dL, procalcitonin 0.13 ng / mL. Evolution:after ruling out viral infection, the patient completed a broad-spectrum antibiotic treatment and underwent suspension of immunosuppressive treatment due to suspected toxicity, with no response. A medullary study by flow cytometry was performed, determining a decrease in the B lymphoid line, and autoimmune cytopenia was concluded as an immunologicalcomplication of the transplant. Outcome:The patient received transfusion therapy (plateletpheresis + concentrated red blood cells). He also received IV methylprednisolone for 3 days and 30 mg prednisone for 14 days with gradual subsequent reduction to start Rituximab and cyclosporine. The treatment with Immunoglobulin 6g IV for 5 days was completed. At discharge, white blood cells: 5080 uL, neutrophils: 67%, hemoglobin: 9.20 g / dL, platelets: 20,000 uL, after 18 days of hospital admission. Conclusion:The results with treatment in this case suggest that it may be reasonable to consider autoimmune cytopenias asa diagnostic hematological manifestation of chronic GVHD. Alternatively, it is possible to treat immune cytopenia with steroids, rituximab, and other immunosuppressants


Subject(s)
Humans , Thrombocytopenia , Peripheral Blood Stem Cell Transplantation , Leukopenia , Autoimmune Diseases
10.
Article in English | WPRIM | ID: wpr-719457

ABSTRACT

Systemic lupus erythematosus (SLE) is a chronic autoimmune disorder of an unknown origin. The role of leptospirosis as a triggering factor for SLE is unknown. This paper reports an uncommon case of SLE following a leptospira infection. A 29-year-old female was referred due to fevers, myalgia, and facial edema with rash. Laboratory investigations revealed a hepatic dysfunction, significantly raised lactate dehydrogenase with marked leukopenia and thrombocytopenia. A diagnosis of leptospirosis was confirmed. The patient was treated with antibiotic therapy for leptospirosis. She developed dyspnea after one week. The echocardiogram revealed global hypokinesia with a decreased ejection fraction. A positivity of antinuclear, anti-DNA, and anti-Smith antibodies, together with clinical and laboratory improvement by steroid therapy, led to the diagnosis of SLE. This case highlights the presence of concurrent SLE and leptospirosis. As the symptoms of SLE are similar to leptospirosis, accurate diagnosis through high suspicion is essential for appropriate treatment.


Subject(s)
Adult , Antibodies , Diagnosis , Dyspnea , Edema , Exanthema , Female , Fever , Humans , Hypokinesia , L-Lactate Dehydrogenase , Leptospira , Leptospirosis , Leukopenia , Lupus Erythematosus, Systemic , Myalgia , Myocarditis , Thrombocytopenia
11.
Article in English | WPRIM | ID: wpr-760226

ABSTRACT

PURPOSE: The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC. METHODS: The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of Pediatrics of Inje University Sanggye Paik Hospital from July 2001 to July 2018, were retrospectively reviewed. RESULTS: Of the 184 patients, 10 (5.4%) developed leukopenia in addition to pancytopenia and 2 (1.0%) developed pancytopenia. Leukopenia developed in 11 days to 14 years after OXC administration and was more frequent in males than in females (male vs. female, 9 vs. 1; Fisher exact test, P0.05, t-test). CONCLUSION: OXC-induced leukopenia is not rare and may result in pancytopenia. Patients being treated with OXC should be regularly monitored for abnormal complete blood count profiles.


Subject(s)
Blood Cell Count , Epilepsy , Exanthema , Female , Humans , Hyponatremia , Leukopenia , Lost to Follow-Up , Male , Medical Records , Movement Disorders , Pancytopenia , Pediatrics , Retrospective Studies
12.
Cancer Research and Treatment ; : 1198-1206, 2019.
Article in English | WPRIM | ID: wpr-763160

ABSTRACT

PURPOSE: Mismatch repair (MMR) deficiency plays a critical role in rectal cancer. This study aimed to explore the associations between genetic variations in seven MMR genes and adverse events (AEs) and survival of patients with rectal cancer treated with postoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Fifty single nucleotide polymorphisms in seven MMR (MLH1, MLH3, MSH2, MSH3, MSH6, PMS1 and PMS2) genes were genotyped by Sequenom MassARRAY method in 365 patients with locally advanced rectal cancer receiving postoperative CRT. The associations between genotypes and AEs were measured by odds ratios and 95% confidence intervals (CIs) by unconditional logistic regression model. The associations between genetic variations and survival were computed by the hazard ratios and 95% CIs by Cox proportional regression model. RESULTS: The most common grade ≥ 2 AEs in those 365 patients, in decreasing order, were diarrhea (44.1%), leukopenia (29.6%), and dermatitis (18.9%). Except 38 cases missing, 61 patients (18.7%) died during the follow-up period. We found MSH3 rs12513549, rs33013 and rs6151627 significantly associated with the risk of grade ≥ 2 diarrhea. PMS1 rs1233255 had an impact on the occurrence of grade ≥2 dermatitis. Meanwhile, PMS1 rs4920657, rs5743030, and rs5743100 were associated with overall survival (OS) time of rectal cancer. CONCLUSION: These results suggest that MSH3 and PMS1 polymorphisms may play important roles in AEs prediction and prognosis of rectal cancer patients receiving postoperative CRT, which can be potential genetic biomarkers for rectal cancer personalized treatment.


Subject(s)
Biomarkers , Chemoradiotherapy , Dermatitis , Diarrhea , DNA Mismatch Repair , Follow-Up Studies , Genetic Variation , Genotype , Humans , Leukopenia , Logistic Models , Methods , Odds Ratio , Polymorphism, Single Nucleotide , Prognosis , Rectal Neoplasms
13.
Article in English | WPRIM | ID: wpr-786498

ABSTRACT

PURPOSE: The aim of this study was to evaluate safety and therapeutic efficacy of lutetium 177 prostate-specific membrane antigen (Lu-177-PSMA) in metastatic castration-resistant prostate cancer (mCRPC) patients with low performance status.METHODS: Twenty-two patients already treated with anti-androgens and docetaxel were enrolled for one cycle of Lu-177-PSMA therapy. Haemoglobin, total leukocyte counts, platelets and serum creatinine for toxicity profile while prostate specific antigen (PSA), Eastern Cooperative Oncology Group (ECOG) performance status, visual analogue scale (VAS) and analgesic quantification scale (AQS) for therapeutic efficacy were recorded pre and 8 weeks post therapy. Wilcoxon signed-rank and ANOVA tests were used for statistical analysis.RESULTS: Partial response (PR), stable disease (SD) and progressive disease (PD) for PSAwere seen in 5 (22.7%), 13 (59.1%) and 4 (18.2%) patients respectively treated with mean 6.88 GBq dose of Lu-177-PSMA. 8/22 (36.4%) patients showed ≥ 30% drop in PSA. Grade 3 haemoglobin toxicity was seen in 5/22 (22.7%) patients. No patient developed grade 4 haemoglobin toxicity. No patients had grade 3 or 4 leukocytopenia or thrombocytopenia. Wilcoxon signed-rank test showed statistical significant (P < 0.05) difference in pre and post treatment ECOG, VAS, and AQS scores. The ANOVA test showed statistically significant difference in mean doses of Lu-177-PSMA used in three PSA response groups while difference was non-significant for other variables.CONCLUSION: We concluded that Lu-177-PSMA therapy has adequate pain palliation in end-stage mCRPC patients with low performance status and it has a potential to become effective therapeutic option in properly selected patients.


Subject(s)
Creatinine , Humans , Leukocyte Count , Leukopenia , Lutetium , Membranes , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms , Thrombocytopenia
14.
Article in Chinese | WPRIM | ID: wpr-771988

ABSTRACT

OBJECTIVE@#To explore the genetic basis of a child affected with refractory leukocytopenia and thrombocytopenia.@*METHODS@#Clinical manifestation and auxiliary examination of the child were discussed. Whole exome next generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA) were used to detected potential mutations of the FANCA gene.@*RESULTS@#Repeated blood tests indicated that the child had abnormal WBC count at (2.7-3.98)×10


Subject(s)
Child , Exons , Fanconi Anemia Complementation Group A Protein , Genetics , Female , Heterozygote , Humans , Leukopenia , Genetics , Mutation , Thrombocytopenia , Genetics
15.
Article in English | WPRIM | ID: wpr-765019

ABSTRACT

BACKGROUND: The objective of this study was to identify the effects of mycophenolate mofetil (MMF) on non-renal manifestations in systemic lupus erythematosus (SLE). METHODS: The study population comprised 439 SLE patients from the Korean Lupus Network registry who were followed up annually and completed the baseline survey and two follow-up visits from 2014 to 2018. Disease activity, laboratory markers, and clinical manifestations including mucocutaneous lesions, arthritis, serositis, neurological disorders, and hematologic/immunologic abnormalities were assessed. All variables by group (MMF and non-MMF) effects with time (baseline, 1st follow-up, and 2nd follow-up) were analyzed by generalized estimation equation. RESULTS: Seventy-two patients were treated with MMF. There was significant difference in frequencies of malar rash, arthritis, renal disorder, and hematologic disorder between MMF and non-MMF groups in total SLE patients. In subgroup analysis of hematologic abnormalities in total patients, frequency of leukopenia was significantly different between the two groups during follow-up (P = 0.001), but frequencies of hemolytic anemia, lymphopenia, and thrombocytopenia were not. In addition, frequencies of leukopenia in patients without lupus nephritis were significantly decreased in MMF group compared to non-MMF group (P = 0.012). CONCLUSION: This study showed that MMF might be a beneficial treatment for hematologic abnormalities, especially leukopenia, in SLE.


Subject(s)
Anemia, Hemolytic , Arthritis , Biomarkers , Exanthema , Follow-Up Studies , Humans , Leukopenia , Lupus Erythematosus, Systemic , Lupus Nephritis , Lymphopenia , Nervous System Diseases , Serositis , Surveys and Questionnaires , Thrombocytopenia
16.
Clinics ; 74: e775, 2019. tab
Article in English | LILACS | ID: biblio-1011898

ABSTRACT

OBJECTIVE: Bilirubin is considered an important antioxidant, anti-inflammatory factor and immunomodulator. The current investigation aimed to explore the association between bilirubin and white blood cell (WBC) count in a large Chinese cohort. METHODS: A total of 61091 participants (29259 males, 31832 females) were recruited from a Chinese tertiary hospital. Data were sorted by sex, and the association between bilirubin and WBC count was analyzed after dividing bilirubin levels into quartiles. RESULTS: Most parameters (including age, body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, total bilirubin, blood urea nitrogen, creatinine, uric acid, triglycerides and WBC count) were significantly higher in men than in women. Bilirubin displayed significant negative relationships with most other measured variables. Linear logistic regression analysis further indicated their negative relationships. Females showed a significantly higher frequency of leucopenia than males. Significant associations of leucopenia with high bilirubin quartiles were shown in binary logistic regression models for both sexes, with a much closer association in men than in women. For instance, for men with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.600-times higher than that of men with values in quartile 1. For women with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.135-times higher than that of women with values in quartile 1. CONCLUSION: Bilirubin is negatively related to WBC count. Significant associations exist between leucopenia and high bilirubin quartiles, and these associations are more obvious in men than in women.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Bilirubin/blood , Leukocyte Count , Reference Values , Body Mass Index , Logistic Models , China/epidemiology , Sex Factors , Incidence , Cross-Sectional Studies , Risk Factors , Age Factors , Leukopenia/etiology , Leukopenia/epidemiology
17.
Article in Korean | WPRIM | ID: wpr-764633

ABSTRACT

PURPOSE: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. METHODS: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. RESULTS: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p < .001), and healthcare costs of 17,052,784 Won (p < .001). CONCLUSION: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.


Subject(s)
Accidental Falls , Adult , Antipsychotic Agents , Case-Control Studies , Education , Electronic Health Records , Health Care Costs , Hematology , Humans , Hypoalbuminemia , Length of Stay , Leukopenia , Linear Models , Logistic Models , Narcotics , Nursing , Retrospective Studies , Risk Assessment , Risk Factors , Self Care , Steroids
18.
Oncol. (Guayaquil) ; 28(3): 219-231, 30 de Diciembre 2018.
Article in Spanish | LILACS | ID: biblio-1000402

ABSTRACT

Introducción: La Neutropenia Febril es una complicación potencialmente fatal del tratamiento del cáncer, relacionada con mayor morbilidad, mortalidad, disminución de dosis o retardo en los ciclos de quimioterapia, y resultados finales pobres. Estudios anteriores han demostrado el beneficio de Factor Estimulante de Colonias de Granulocitos en la reducción de tiempo de hospitalización, antibióticos intravenosos, fiebre y recuperación del conteo absoluto de neutrófilos. Se decide realizar el presente reporte ya que no existen datos respecto al manejo y respuesta al tratamiento en nuestro medio. Métodos: El presente estudio descriptivo, retrospectivo, fue realizado en el Instituto del Cáncer SOLCA ­ Cuenca. Se revisaron las historias clínicas del período 2010 ­ 2011. Las variables analizadas fueron: número de días de hospitalización, fiebre, uso de antibióticos intravenosos, y días de recuperación de neutropenia a >500/mm3 y >1000/mm3. Resultados: La estancia hospitalaria tuvo una mediana de 6 días, los días de terapia antibiótica intravenosa fueron iguales a los días de hospitalización. 79 eventos se recuperaron a un conteo absoluto de neutrófilos >500/mm3, en una mediana de 4 días; 72 eventos se recuperaron a >1000 /mm3 en una mediana de 4 días. La mayoría de los eventos se volvieron afebriles en una mediana de 1 día. Conclusión: Los resultados de las variables estancia hospitalaria, uso de antibióticos intravenosos y la duración de la fiebre fueron similares a los ya descritos en estudios anteriores, la recuperación del conteo absoluto de neutrófilos, fue más tardía, mostrando diferencias importantes con la bibliografía.


Introduction: Febrile Neutropenia is a potentially fatal complication of cancer treatment, related to higher morbidity, mortality, dose reduction or retard in chemotherapy cycles, and poor final outcomes. Previous studies have demonstrated the benefit of G-CSF (Granulocyte ­ Colony Stimulating Factors) in reduction of hospital stay, the use of intravenous antibiotics, fever and absolute neutrophil count (ANC) recovery. There is no data about the management and treatment response in our population. Methods: This is a retrospective descriptive study, developed in SOLCA ­ Cuenca Cancer Institute. 83 febrile neutropenia events met the inclusion and exclusion criteria, medical records from years 2010 to 2011 were reviewed. The analyzed variables were: days of hospital stay, fever, intravenous antibiotics use, and neutropenia recovery to a level >500/mm3 and >1000/mm3. Results: The median of hospital stay was 6 days, the duration of IV antibiotic therapy was the same as the days of hospital stay. 79 events recovered to an ANC >500/mm3, with a median of 4 days; 72 events recovered to >1000 /mm3 with a median of 4 days. The majority of events became afebrile with a median of 1 day. Conclusion: The results in the variables hospital stay, use of intravenous antibiotics and fever duration, were similar to those described in previous studies. The ANC recovery was delayed, showing important differences with cited references.


Subject(s)
Humans , Granulocyte Colony-Stimulating Factor , Fever , Leukopenia , Morbidity , Neoplasms , Neutrophils
19.
Acta cir. bras ; 33(12): 1103-1109, Dec. 2018. tab
Article in English | LILACS | ID: biblio-973490

ABSTRACT

Abstract Purpose: To evaluate a possible relationship between the size of the spleen and values of circulating blood elements in patients with schistosomatic splenomegaly. Methods: ixty one patients with hepatosplenic schistosomiasis mansoni underwent a clinical exam and peripheral venous blood was collected for a hemogram. The erythrocyte, hemoglobin, hematocrit, leukocyte, and platelet values were determined. All patients underwent abdominal ultrasound to measure the spleen. The hematological test results were compared to the size of the spleen. Results: The size of the spleen varied from 14.0 to 28.4 (19.9 ± 3.7) cm according to the ultrasound image. Thrombocytopenia was observed 58 (95%) patients, leukopenia in 55 (90%) patients, and anemia in 32 (52.4%) patients. Leukopenia was proportional to splenomegaly. Conclusion: Schistosomal splenomegaly leads to leukopenia in direct proportion to the size of the spleen.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Spleen/pathology , Splenomegaly/pathology , Splenomegaly/blood , Schistosomiasis mansoni/pathology , Schistosomiasis mansoni/blood , Organ Size , Reference Values , Spleen/parasitology , Splenomegaly/parasitology , Thrombocytopenia/parasitology , Blood Cell Count , Body Height , Body Weight , Hemoglobins/analysis , Body Mass Index , Leukopenia/parasitology
20.
Acta méd. colomb ; 43(1): 20-23, ene.-mar. 2018. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-949530

ABSTRACT

Resumen Introducción: la infección viral más importante postrasplante renal es la infección por citomegalovirus (CMV), hay discrepancia entre centros y países en datos de incidencia de infección-enfermedad en esta población de pacientes. Diseño: se realiza un estudio observacional analítico, tomando una cohorte retrospectiva de pacientes mayores de 18 años, trasplantados renales de donante vivo o cadavérico entre el 2004 y 2015 con al menos seis meses de seguimiento. Material y métodos: se realiza muestreo no probabilístico por conveniencia, se toman los datos de las historias clínicas de los pacientes trasplantados renales, calculando la densidad de incidencia de infección-enfermedad por CMV y se describen las características clínicas y demográficas de los pacientes que presentaron estas patologías. Resultados: se analizaron 252 pacientes, encontrando 92.4% receptores con riesgo intermedio para CMV y 7.5% con riesgo alto, ninguno fue de riesgo bajo. Se identificaron 19 casos, 13 con infección (5.1%) y seis con enfermedad (2.3%). El compromiso gastrointestinal fue el más frecuente. El tiempo promedio desde el momento del trasplante hasta la aparición de la infección-enfermedad fue de 417 (±479) y 650 días (±481), respectivamente. La tasa de infección fue de 10.08 casos por 1000 pacientes/año y la tasa de enfermedad de 5.88 por 1000 pacientes/año. Conclusiones: la densidad de incidencia de infección-enfermedad por CMV en pacientes trasplantados renales fue de 10.08 casos y 5.88 casos por 1000 pacientes/año, respectivamente. Estas tasas son menores a las reportados en la literatura. Dada la baja frecuencia de eventos, no fue posible establecer factores de asociación.


Abstract Introduction: the most important viral infection after renal transplantation is cytomegalovirus (CMV) infection. There is a discrepancy between centers and countries in terms of incidence data of infection-disease in this population of patients. Design: an analytical observational study was conducted, taking a retrospective cohort of patients older than 18 years old, kidney transplant recipients of living or cadaveric donors between 2004 and 2015, with at least 6 months of follow-up. Material and methods: non-probability convenience sampling was done; data from the clinical records of the kidney transplant patients were taken, calculating the incidence density of CMV infection-disease and the clinical and demographic characteristics of the patients who presented these pathologies were described. Results: 252 patients were analyzed; 92.4% of recipients with intermediate risk for CMV and 7.5% with high risk were found. None of them had low risk. 19 cases were identified, 13 with infection (5.1%) and 6 with disease (2.3%). Gastrointestinal involvement was the most frequent. The average time from the time of transplant to the onset of the infection-disease was 417 (± 479) and 650 days (± 481), respectively. The infection rate was 10.08 cases per 1000 patients / year and the disease rate was 5.88 per 1000 patients/year. Conclusions: the incidence density of CMV infection-disease in renal transplant patients was 10.08 cases and 5.88 cases per 1000 patients / year, respectively. These rates are lower than those reported in the literature. Given the low frequency of events, it was not possible to establish association factors. (Acta Med Colomb 2018; 43: 20-23).


Subject(s)
Male , Female , Adult , Cytomegalovirus , Kidney Transplantation , Valganciclovir , Leukopenia
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