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1.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1310, ene.-mar. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251720

ABSTRACT

Introducción: Los síndromes mielodisplásicos constituyen un grupo heterogéneo de desórdenes hematológicos clonales adquiridos, que afectan la célula madre. Se caracterizan morfológicamente por: hematopoyesis ineficaz, citopenias periféricas progresivas, displasia en uno o más linajes celulares y tendencia evolutiva a leucemia aguda. Los avances recientes en la comprensión de los mecanismos genéticos y moleculares de los síndromes mielodisplásicos, han revelado la asociación entre alteraciones inmunológicas y las mutaciones recurrentes. Las células de la respuesta inmune innata y adaptativa, así como diversos mediadores solubles liberados por ellas, pueden establecer una respuesta antitumoral protectora o, por el contrario, inducir eventos de inflamación crónica que favorezcan la promoción y progresión de esta enfermedad. Objetivos: Resumir los conocimientos actuales de la relación sistema inmune-síndromes mielodisplásicos, enfatizando en las células inmunes del microambiente de la médula ósea y su importancia en la clínica de la enfermedad. Métodos: Se realizó investigación bibliográfica-documental acerca del tema. Se consultaron las bases de datos Scielo y Pubmed. Conclusiones: La comprensión de la función dual que ejerce el sistema inmune en los síndromes mielodisplásicos, constituye un desafío y son necesarios estudios clínicos rigurosos para poder establecer el valor de la manipulación del sistema inmune como una forma posible de tratamiento de esta enfermedad(AU)


Introduction: Myelodysplastic syndromes (MDS) constitute a heterogeneous group of acquired clonal hematological disorders that affect the stem cell. These are characterized morphologically and clinically by: ineffective hematopoiesis, progressive peripheral cytopenia, dysplasia in one or more cell lineages, in most of cases and evolutionary tendency to acute leukemia. Recent advances in understanding the genetic and molecular mechanisms of MDS have revealed the association between immunological alterations and recurrent mutations. Cells of the innate and adaptive immune response, as well as various soluble mediators released by them, can establish a protective antitumor response or, on the contrary, induce events of chronic inflammation that favor the promotion and progression of this disease. Objective: To summarize the current knowledge of the immune system-MDS relationship, emphasizing the immune cells of the bone marrow microenvironment and their importance in the clinic of the disease. Methods: A bibliographic-documentary research was carried out on the subject. The Scielo and Pubmed databases were consulted. Conclusions: Understanding the dual role of the immune system in MDS constitutes a challenge and rigorous clinical studies are necessary to establish the value of manipulating the immune system as a possible form of treatment of this disease(AU)


Subject(s)
Humans , Stem Cells , Myelodysplastic Syndromes/complications , Leukemia , Adaptive Immunity , Hematopoiesis/genetics , Immune System/physiopathology , Inflammation/diagnosis
2.
Rev. bras. ciênc. saúde ; 24(3): 465-474, set. 25, 2020. tab
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-MA | ID: biblio-1179431

ABSTRACT

Objetivo: Avaliar o perfil nutricional de pacientes onco-hematológicos internados em um hospital especializado em câncer em São Luís - MA. Metodologia: Estudo transversal, retrospectivo, analítico, com coleta de dados secundária, envolvendo pacientes com idade mínima de 18 anos, de ambos os gêneros e que tenham sido submetidos a pelo menos uma ASG-PPP (Avaliação Subjetiva Global Produzida Pelo Paciente). Os dados foram coletados em registros do Serviço de Nutrição e Dietética do hospital. Analisaram-se dados demográficos (gênero e idade), clínicos (diagnóstico) e nutricionais: Índice de massa corporal (IMC), circunferên-cia braquial (CB), prega cutânea tricipital (PCT), circunferência muscular do braço (CMB) e ASG-PPP. As análises foram realizadas no programa estatístico Stata® 13.0. O nível de significância utilizado para os testes foi de p<0,05. Resultados: Foram avaliados 330 pacientes, onde foi constatado que 67,58% eram de adultos e 32,42% de idosos, com maior frequência do sexo masculino, com 60,30%. Ocorreu maior incidência de leucemia (58,48%), seguidos de linfomas (24,85%), mieloma múltiplo (13,33%) e síndrome mielodisplásica (3,3%). Na avaliação do estado nutricional os resultados mostraram que a ASG-PPP detectou maior número de pacientes com algum grau de desnutrição do que outros indicadores (93,94%), seguido pela PCT (65,76%), CMB (53,64%), CB (45,45%) e IMC (14,87%). De acordo com o IMC, foi encontrado maior incidência de eutrofia, correspondendo a 57,27% da amostra. Conclu-são: Diante do que foi encontrado, destaca-se que a desnutrição é um aspecto de extrema importância a ser considerado no tratamento de pacientes onco-hematológicos, visto que pode interferir diretamente no prognóstico da doença. (AU)


Objective: To evaluate the nutritional profile of onco-hematological patients admitted to a specialized cancer hospital in São Luís - MA. Methodology: Cross-sectional, retrospective, analytical study, with secondary data collection, involving patients aged at least 18 years, of both genders and having undergone at least one ASG-PPP (Subjective Global Assessment Produced by the Patient). Data were collected from records of the Hospital's Nutrition and Dietetics Service. Demographic (gender and age), clinical (diagnostic) and nutritional: Body Mass Index (BMI), Brachial Circumference (CB), Tricipital Skinfold (PCT), Muscular Arm Circumference (CMB) and ASG-PPP data were analyzed. The analyses were performed using the Stata® 13.0 statistical program. The level of significance used for the tests was p<0.05. Results: 330 patients were evaluated, in which it was found that 67.58% are adults and 32.42% are elderly, with a higher frequency of males with 60.30%. There was a higher incidence of Leukemia (58.48%), followed by Lymphomas (24.85%), Multiple Myeloma (13.33%) and Myelodysplastic Syndrome (3.3%). In the assessment of nutritional status, the results showed that ASG-PPP detected a greater number of patients with some degree of malnutrition than other indicators (93.94%), followed by PCT (65.76%), CMB (53.64%), CB (45.45%) and BMI (14.87%). According to the BMI, a higher incidence of eutrophy was found, which corresponds to 57.27% of the sample. Conclusion: In view of what was found, it is highlighted that malnutrition is an extremely important aspect to be considered in the treatment of onco-hematological patients, since it can directly interfere in the prognosis of the disease. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Myelodysplastic Syndromes/complications , Leukemia/complications , Nutritional Status , Malnutrition/etiology , Lymphoma/complications , Cross-Sectional Studies , Retrospective Studies
4.
Article in English | WPRIM | ID: wpr-181487

ABSTRACT

Endoscopic submucosal dissection (ESD) has been successfully performed in thrombocytopenic conditions such as in patients with liver cirrhosis but successful ESD for early gastric cancer (EGC) in hematologic diseases has rarely been reported. A 52-year-old male patient, who had previously been diagnosed with myelodysplastic syndrome 2 years ago, was admitted to our hospital for ESD of EGC. ESD was performed successfully in this patient after platelet concentrates transfusion on the day of ESD. ESD might be an option for the treatment of EGC in thrombocytopenia due to hematologic diseases when optimal supportive managements are applied.


Subject(s)
Early Detection of Cancer , Endosonography , Gastric Mucosa/surgery , Gastroscopy , Humans , Male , Middle Aged , Myelodysplastic Syndromes/complications , Stomach Neoplasms/complications , Tomography, X-Ray Computed
6.
Rev. Soc. Bras. Clín. Méd ; 11(3)jul.-set. 2013.
Article in Portuguese | LILACS | ID: lil-686979

ABSTRACT

As infecções de tecidos moles causadas por espécies de Clostridium têm sido descritos na literatura por centenas de anos. A gangrena gasosa por Clostridium continua sendo uma importante causa de morbidade e mortalidade no mundo. O objetivo deste estudo foi relatar um caso de paciente com diagnóstico de síndrome mielodisplásica, submetida à curetagem uterina e evoluindo com gangrena gasosa espontânea, 10 horas após a cirurgia.Paciente do sexo feminino, 26 anos, com história de dor em terço distal de membros inferiores, irradiando para região de fossa poplítea, com piora à palpação e movimentação dos membros, acompanhada de aumento da temperatura e volume local. Negava febre, hiperemia ou trauma local, evoluindo para choque séptico. Angiotomografia das extremidades e pelve revelou a presença de gás permeando os feixes musculares da coxa e da perna, bilateralmente. A combinação da história e exame clínico,ao estudo radiológico confirmou o diagnóstico sindrômico de gangrena gasosa espontânea. Apesar de elevado índice de suspeição melhorar os resultados clínicos, tais infecções progridem tão rapidamente que o óbito pode preceder o diagnóstico,não obstante, o reconhecimento precoce e tratamento agressivo,incluindo drenagem aberta ou percutânea. Antibióticos parenterais contra Clostrídios devem ser prontamente iniciados, bem como medidas de suporte clínico.


The soft tissue infections caused by Clostridium species have been described in the literature for hundreds of years. The gas gangrene due to Clostridium remains an important cause of morbidity and mortality worldwide. The aim of this study was to report a patient diagnosed with myelodysplastic syndrome who underwent curettage, evolving with spontaneous gas gangrene, 10 hours after surgery. Female patient, 26 years, with pain in the distal third of the lower limbs, radiating to the popliteal fossa region, which worsened on palpation and movement of limbs, and accompanied by an increase in temperature and local volume. She denied fever, redness or local trauma, and progressed to septic shock. Angiotomography of the extremities and pelvis revealed the presence of gas permeating the muscle bundles of the thigh and leg bilaterally. The combination of history and clinical examination and radiological examination confirmed the syndromic diagnosis of Spontaneous Gas Gangrene. Although a high index of suspicion may improve clinical outcomes, such infections progress so rapidly that death usually precedes the diagnosis. However, early recognition and aggressive treatment, including open or percutaneous drainage and parenteral antibiotics against Clostridia should be promptly initiated, along with clinical support.


Subject(s)
Humans , Female , Adult , Gas Gangrene/complications , Gas Gangrene/diagnosis , Clostridium Infections/complications , Clostridium Infections/diagnosis , Sepsis/complications , Myelodysplastic Syndromes/complications
8.
Article in English | WPRIM | ID: wpr-69775

ABSTRACT

We report here a case of inguinal sparganosis, initially regarded as myeloid sarcoma, diagnosed in a patient undergone allogeneic hematopoietic transplantation (HSCT). A 56-year-old male patient having myelodysplastic syndrome was treated with allogeneic HSCT after myeloablative conditioning regimen. At day 5 post-HSCT, the patient complained of a painless palpable mass on the left scrotum and inguinal area. Pelvic magnetic resonance imaging and computed tomography revealed suspected myeloid sarcoma. Gun-biopsy was performed, and the result revealed eosinophilic infiltrations without malignancy. Subsequent serologic IgG antibody test was positive for sparganum. Excisional biopsy as a therapeutic diagnosis was done, and the diagnosis of sparganosis was confirmed eventually. This is the first report of sparganosis after allogeneic HSCT mimicking myeloid sarcoma, giving a lesson that the physicians have to consider the possibility of sparganosis in this clinical situation and perform adequate diagnostic and therapeutic approaches.


Subject(s)
Animals , Diagnosis, Differential , Hematopoietic Stem Cell Transplantation , Humans , Larva , Magnetic Resonance Imaging , Male , Middle Aged , Myelodysplastic Syndromes/complications , Republic of Korea , Sarcoma, Myeloid/diagnosis , Scrotum/parasitology , Sparganosis/parasitology , Sparganum/immunology , Tomography, X-Ray Computed , Transplantation, Homologous
9.
Article in English | WPRIM | ID: wpr-125849

ABSTRACT

An 87-yr-old woman was diagnosed with AML with myelodysplasia-related changes (AML-MRC). The initial complete blood count showed Hb level of 5.9 g/dL, platelet counts of 27x10(9)/L, and white blood cell counts of 85.33x10(9)/L with 55% blasts. Peripheral blood samples were used in all the tests, as bone marrow examination could not be performed because of the patient's extremely advanced age and poor general health condition. Flow cytometric analysis, chromosome analysis, FISH, and reverse transcriptase-PCR (RT-PCR) results indicated AML-MRC resulting from t(3;21) with the RUNX1-MECOM fusion gene. To our knowledge, this is the second most elderly de novo AML patient associated with t(3;21) to be reported.


Subject(s)
Aged, 80 and over , Blood Cells/pathology , Chromosomes, Human, Pair 21 , Chromosomes, Human, Pair 3 , Female , Humans , Karyotyping , Leukemia, Myeloid, Acute/complications , Multiplex Polymerase Chain Reaction , Myelodysplastic Syndromes/complications , Oncogene Proteins, Fusion/genetics , Sequence Analysis, DNA , Translocation, Genetic
11.
An. bras. dermatol ; 86(4,supl.1): 173-177, jul,-ago. 2011. ilus, tab
Article in Portuguese | LILACS | ID: lil-604152

ABSTRACT

Certas dermatoses, pertencentes ao grupo das síndromes paraneoplásicas mucocutâneas, podem ser o prenúncio de uma neoplasia previamente não conhecida. Tanto a síndrome de Sweet como a policondrite recidivante incluem-se neste grupo. A síndrome de Sweet e a PR são raramente encontradas em um mesmo paciente. A presença de policondrite recidivante e síndrome de Sweet em um mesmo paciente tem se revelado mais frequente em pacientes com neoplasias associadas, sobretudo hematológicas. Relata-se o caso de paciente do sexo masculino, 79 anos, com síndrome de Sweet e policondrite recidivante, em quem, subsequentemente, foi diagnosticada uma síndrome mielodisplásica.


The emergence of certain skin conditions belonging to the group of mucocutaneous paraneoplastic syndromes may indicate the future appearance of a previously unknown malignancy. Sweet's Syndrome and relapsing polychondritis are included in this group. Sweet's Syndrome and relapsing polychondritis are very rarely found together in the same patient. This dual occurrence is more commonly found in cancer patients with associated hematological malignancies. We report the case of a 79year-old male with Sweet's Syndrome and relapsing polychondritis, who was subsequently diagnosed with a myelodysplastic syndrome.


Subject(s)
Aged , Humans , Male , Myelodysplastic Syndromes/complications , Polychondritis, Relapsing/etiology , Polychondritis, Relapsing/pathology , Sweet Syndrome/etiology , Sweet Syndrome/pathology , Myelodysplastic Syndromes/pathology , Recurrence
12.
GEN ; 64(4): 356-358, dic. 2010. graf
Article in Spanish | LILACS | ID: lil-664524

ABSTRACT

La trombosis venosa portal extrahepática (TVPHE) ocurre en etapas tempranas de la vida como complicación de onfalitis, canulación de vena umbilical, sepsis intraabdominal, deshidratación y estados de hipercoagulabilidad. En la adultez, se describe la asociación a estados de hipercoagulabilidad, principalmente deficiencias de proteínas C y S, postraumática, manipulación portal, pancreatitis, así como obstrucción o invasión tumoral. En la mitad de estos casos, la etiología es desconocida. Hay reportes en la literatura de TVPEH asociada a procesos infecciosos severos como sepsis por Fusobacterium necrophorum, Fusobacterium nucleatum, así como infección por Citomegalovirus; sin embargo estos reportes son muy escasos. Paciente femenino de 56 años de edad, con antecedente de síndrome mielodisplásico, quien acude por clínica de dolor abdominal difuso, ictericia obstructiva y trastornos en el funcionalismo hepático. Dentro de las evaluaciones efectuadas se realiza Ultrasonido Endoscópico (USE) con evidencia de trombosis venosa profunda portal y mesentérica superior con hipertensión portal, várices esofágicas y fundicas. Se plantea probable origen infeccioso por lo que se solicita serologia para CMV con niveles elevados de IgG, se inicia tratamiento antiviral con valganciclovir y betabloquenates con evolución satisfactoria luego de un año. Conclusión: A pesar de que la trombosis venosa portal asociada a la infección por CMV es un evento poco frecuente en individuos inmunocompetentes, el descarte de esta debe ser incluida dentro del plan diagnóstico de trombosis del lecho esplenoportal...


Extrahepatic portal vein thrombosis (EHPVT) occurs in early stages of life as a complication of omphalitis, cannulation of the umbilical vein, intra-abdominal sepsis, dehydration, and hypercoagulable states, mainly C and S proteins deficiencies, post-traumatic, portal vein manipulation, pancreatitis, as well as tumor invasion or obstruction. Etiology is unknown in half of these cases. In the literature, there are reports of EHPVT associated with severe infectious processes such as sepsis by Fusobacterium necrophorum, Fusobacterium nucleatum, as well as infection by Cytomegalovirus (CMV). Nonetheless, such reports are very scarce. Female patient aged 56, con antecedent myelodysplastic syndrome, who attends the clinic with diffuse abdominal pain, obstructive icterus, and liver function disturbances. Among the assessments performed, an Endoscopic Ultrasound (EUS) is carried out evidencing upper mesenteric and deep portal vein thrombosis with portal hypertension, esophageal and fundic varices. A probable infectious origin is stated, thus serology is requested for CMV with elevated levels of IgG; antiviral treatment is started with Valgancyclovir and Beta-Blockers with satisfactory evolution after one year. Conclusion: Despite the portal vein thrombosis associated with the infection by CMV is a rare event in immunocompetetnt persons, discarding it must be included in a diagnosis plan for splenic-portal bed thrombosis...


Subject(s)
Humans , Female , Middle Aged , Endoscopy, Gastrointestinal/methods , Cytomegalovirus Infections/complications , Cytomegalovirus Infections/diagnosis , Myelodysplastic Syndromes/complications , Myelodysplastic Syndromes/diagnosis , Venous Thrombosis/pathology , Portal Vein/injuries , Gastroenterology
13.
Yonsei Medical Journal ; : 244-247, 2010.
Article in English | WPRIM | ID: wpr-228995

ABSTRACT

PURPOSE: We performed this study in order to evaluate the incidence and characteristics of urolithiasis in patients with malignant hematologic diseases. MATERIALS AND METHODS: Nine hundred one patients who underwent medical treatment for malignant hematologic disease and 40,543 patients who visited the emergency room and without malignant hematologic diseases were included in our study. The patients with malignant hematologic diseases were divided into two groups depending on their primary treatment. Group I included patients with acute and chronic leukemia (AML, ALL, CML, CLL) for which chemotherapy and steroid therapy was necessary, and group II included patients with anaplastic anemia and myelodysplastic syndrome and who had undergone repeated transfusion for treatment. Comparisons were made between the two groups in respect to the incidence of urolithiasis and the stones' radiopacity. RESULTS: Twenty nine patients (3.2%) of the 901 malignant hematologic patients were diagnosed with urolithiasis, compared to 575 patients (1.4%) of 40,543 emergency room patients. There was a significant increase of the incidence of urolithiasis in the malignant hematologic group. Compared to the general patients, the patients with malignant hematologic diseases had a higher rate of radiolucent stones (46.6% versus 16.3%, respectively), and the difference was significant. CONCLUSION: The incidence of urolithiasis for malignant hematologic patients was significantly higher than that for the control group.


Subject(s)
Adult , Aged , Female , Hematologic Diseases/complications , Humans , Incidence , Leukemia/complications , Male , Middle Aged , Myelodysplastic Syndromes/complications , Retrospective Studies , Urolithiasis/epidemiology , Young Adult
14.
Article in Korean | WPRIM | ID: wpr-164244

ABSTRACT

BACKGROUND: AML with myelodysplasia related changes (AML MRC) is known to show a poor prognosis compared with de novo AML, but controversies exist about the prognostic impact of multilineage dysplasia (MLD) among MRC. We investigated the prognostic impact of MLD in AML MRC. METHODS: A total of 357 patients newly diagnosed as AML at Asan Medical Center from January 2001 to December 2005 were analyzed. They were diagnosed and classified as AML with recurrent genetic abnormalities, AML MRC, and AML not otherwise specified (AML NOS). Prognostic markers including overall survival (OS) and event free survival (EFS) were obtained through retrospective analysis of electronic medical records. RESULTS: AML MRC patients showed a lower complete remission (CR) rate (44.7% vs. 64.9%, P=0.002) and shorter OS (297 vs. 561 days, P=0.004) and EFS (229 vs. 374 days, P=0.004) than AML NOS patients. Patients with MLD among AML MRC also showed a lower CR rate (37.7%, P=0.001) and shorter OS (351 days, P=0.036) and EFS (242 days, P=0.076) than AML NOS patients. However, among AML MRC patients, there were no differences in OS, EFS and CR between patients with and without MLD. CONCLUSIONS: AML MRC patients showed a lower CR rate and shorter OS and EFS than AML NOS patients. AML MRC patients with MLD showed similar results and their prognosis was not different from those without MLD. MLD findings among AML MRC could be an independent poor prognostic factor in de novo AML.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Cell Lineage , Child , Child, Preschool , Data Interpretation, Statistical , Disease-Free Survival , Female , Humans , Infant , Leukemia, Myeloid, Acute/complications , Male , Middle Aged , Myelodysplastic Syndromes/complications , Prognosis , Retrospective Studies , Survival Analysis
15.
Rev. chil. pediatr ; 80(4): 354-360, ago. 2009. ilus
Article in Spanish | LILACS | ID: lil-556703

ABSTRACT

Introduction: Peliosis hepatis (PH) is an uncommon condition in pediatrics; however, it is one of the most serious complications associated with the long-term use of use of steroids. It is characterized by multiple blood-filled cavities, mostly involving the liver. Myelodysplastic Syndrome (MDS) is also a complex and infrequent hematological condition; it may transform into acute leukemia and its treatment requires medications that may lead to PH. Case Report: 13 year-old girl with MDS, refractory cytopenia type. A family donor for SCL was not available, therefore immunosuppressive treatment, steroids and transfusions were initiated. Due to metrorrhage, estrogen was used at high doses. She developed acute abdominal pain; abdominal ultrasound and CL scan showed PH and peritoneal bleeding. Oral contraceptives were decreased resulting in reduction of PH, but a new episode of uterine bleeding causing hypovolemic shock forced a hysterectomy in order to suspend estrogen treatment. Due to lack of response to treatment to SMD, she continued been treated with transfusions as needed, and died 32 months post diagnosis. Discussion: PH is an uncommon and life-threatening condition in children receiving prolonged treatment with steroids. Current modalities of SCL in patients with MDS will replace the need for steroids, thus avoiding this severe complication.


Introducción: La Peliosis Hepática (PH) es una condición muy infrecuente en pediatría, caracterizada por la presencia de múltiples cavidades sanguíneas en el parénquima hepático, asociada al uso prolongado de estrógenos o corticoides, El Síndrome Mielodisplásico (SMD) es una alteración hematológica compleja que puede evolucionar a leucemia y que puede requerir para su tratamiento medicamentos relacionados al desarrollo de PH. Caso Clínico: Niña 13 años, con SMD tipo citopenia refractaria, con dependencia transfusional, sin posibilidad de realizar Trasplante de progenitores hematopoyéticos (TPH) por falta de donante familiar compatible. Recibió transfusiones, inmunosupresores y corticoides por tiempo prolongado. Presentó metrorragias severas requiriendo estrógenos en altas dosis. Evolucionó con hemoperitoneo, diagnosticándose PH por ecografía y scanner abdominal. Al reducir dosis de estrógenos disminuyeron lesiones hepáticas, pero nuevo episodio de metrorragia con shock hipovolémico, obligó a realizar histerectomía para suspender estrógenos. Sin respuesta a tratamiento del SMD, se mantuvo con transfusiones según requerimiento y falleció a los 32 meses del diagnóstico. Discusión: La PH es una complicación grave, que podría evitarse con el desarrollo de nuevas técnicas de TPH que permiten contar con donantes no relacionados para el tratamiento de síndromes de falla medular como el SMD.


Subject(s)
Humans , Adolescent , Female , Steroids/adverse effects , Peliosis Hepatis/chemically induced , Myelodysplastic Syndromes/drug therapy , Contraceptives, Oral/adverse effects , Adrenal Cortex Hormones/adverse effects , Steroids/therapeutic use , Fatal Outcome , Peliosis Hepatis/etiology , Myelodysplastic Syndromes/complications , Time Factors
18.
Article in Korean | WPRIM | ID: wpr-219027

ABSTRACT

A 32-yr-old male diagnosed with myelodysplastic syndrome underwent an unmanipulated, unrelated, HLA matched, peripheral blood stem cell transplantation. The patient and donor were both blood type O, CcDEe. Twelve weeks post-transplantation, he developed acute autoimmune hemolytic anemia (AIHA). He was transfused multiple times with washed O red cells. High-dose steroid therapy was initiated and he underwent splenectomy; however, AIHA was refractory to therapy. The patient was further treated with combined treatment modalities including immunosuppressive therapy with mycophenolate mofetil and cyclosporine and three cycles of plasma exchange, and AIHA responded to treatment. This is the third case of AIHA complicating hematopoietic stem cell transplantation reported in Korea. Since AIHA is relatively common after hematopoietic stem cell transplantation, accurate and timely diagnosis of the disease and treatment strategies with multiple modalities are necessary.


Subject(s)
Adult , Anemia, Hemolytic, Autoimmune/diagnosis , Combined Modality Therapy , Cyclosporine/therapeutic use , Hematopoietic Stem Cell Transplantation/adverse effects , Humans , Male , Mycophenolic Acid/analogs & derivatives , Myelodysplastic Syndromes/complications , Plasma Exchange
19.
Arq. bras. cardiol ; 87(5): e168-e171, nov. 2006. ilus
Article in Portuguese | LILACS | ID: lil-452158

ABSTRACT

Homem de 61 anos de idade, com diagnóstico de síndrome mielodisplásica e angina instável foi submetido a angiografia coronariana e implante de stent. O hemograma revelou 40.000/mm³ plaquetas. A angiografia coronariana, precedida por transfusão de plaquetas, revelou obstrução de 80 por cento no óstio da artéria coronariana direita (ACD). Após o uso de clopidogrel 75mg, o paciente foi submetido à nova transfusão de plaquetas e a implante de stent LEKTON 3,0x10mm na lesão da ACD. Não ocorreram sangramentos após as retiradas dos introdutores. Após seis meses, o teste de esforço foi positivo e nova angiografia, sob as mesmas condições anteriores, mostrou reestenose intra-stent. Esse relato sugere que o implante de stent coronariano em pacientes com plaquetopenia é seguro, contanto que se realize a transfusão profilática de plaquetas, embora em longo prazo possa haver reestenose.


Sixty-one-year-old male patient with diagnosis of myelodysplastic syndrome and unstable angina was submitted to coronary angiography and implant of stent. His Blood vell count revealed 40,000 platelets/mm³. Coronary angiography with previous platelet transfusion showed obstruction of 80 percent of the right coronary artery (RCA). Following the administration of clopidogrel, the patient was submitted to another platelet transfusion and stent implantation in the RCA lesion. No bleeding was observed after the introducers removal. After 6 months, treadmill test was positive and new coronary aniography, in the same conditions, showed in-stent restenosis. This case report suggests that coronary stent implantation in patients with thrombocytopenia is a safe procedure, provided that prophylactic platelet transfusion is performed, although late restenosis may occur.


Subject(s)
Humans , Male , Middle Aged , Angioplasty, Balloon, Coronary , Angina, Unstable/therapy , Myelodysplastic Syndromes/therapy , Stents , Ticlopidine/analogs & derivatives , Angina, Unstable/complications , Angina, Unstable/diagnosis , Coronary Angiography , Myelodysplastic Syndromes/complications , Myelodysplastic Syndromes/diagnosis , Platelet Transfusion , Platelet Aggregation Inhibitors/therapeutic use , Treatment Outcome
20.
J Indian Med Assoc ; 2006 Nov; 104(11): 639-40, 644
Article in English | IMSEAR | ID: sea-96195

ABSTRACT

A 28-year-old woman presented with severe anaemia in pregnancy at a period of gestation of 20 weeks. She was immediately admitted and after proper investigation it was seen that her Hb was 3.5 g/dl and platelet count was 62,000/cmm, RBC showed normocytic, normochromic morphology. There was neither hepatosplenomegaly nor any purpuric spot over the body. Bone marrow showed dyserythropoiesis and its chromosomal study revealed monosomy-7. Her pregnancy was continued till term with repeated packed cell and platelet concentrate transfusions. Normal healthy baby was delivered by caesarean section and she was discharged after 6 days.


Subject(s)
Adult , Anemia/etiology , Female , Humans , Myelodysplastic Syndromes/complications , Pregnancy , Pregnancy Complications, Hematologic , Prognosis , Severity of Illness Index
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