Absolute Lymphocyte Count at the End of Induction as a Surrogate Marker for Minimal Residual Disease in T-cell Acute Lymphoblastic Leukemia

Objective: The relation of absolute lymphocyte count (ALC) with minimal residual disease(MRD) in T cell – acute lymphoblastic leukemia (T-ALL) is not known. The objective of thestudy was to correlate ALC with MRD, steroid-response and complete remission (CR).Methods: De-novo T- ALL patients (age 1-18 y) recruited prospectively; 52 enrolled, 9excluded, and 43 analyzed. 39 achieved CR and MRD was available for 28 patients; 23 wereMRD negative. Results: ALC did not correlate with steroid response and CR. Median (range)ALC at the end of induction was significantly higher in patients who were MRD negativecompared to MRD positive [1.24 (0.12, 6.69) vs 0.62 (0.15, 0.87); P=0.03], respectively.Patients having ALC ≥700 ×109 /L were significantly more likely to be MRD negative thanthose with lower values (P= 0.028) Conclusion: Our study suggests that ALC is a favorablefactor, and may act as surrogate marker for MRD

Hashimoto‘S Encephalopathy Case Reports Of Hashimoto‘S Encephalopathy In Tertiary Care Hospital

Hashimoto's encephalopathy (HE) is an uncommon syndrome and rare disease, associated with Hashimoto thyroiditis. It is characterized by a acute to chronic loss of cognitive dysfunction ,subacute onset of confusion with altered level of consciousness, stroke like episodes , neuropsychiatric manifestations ,seizures, and myoclonus. HE is believed to be an immune-mediated disorder rather than representing the direct effect of an altered thyroid state on the central nervous system. Hashimoto encephalopathy or Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) and a more general term, nonvasculitic autoimmune meningoencephalitis, are also used to describe this condition. Here we are reporting 3 cases of hashimoto encephalopathy in the tertiary care centre who presented with acute to chronic memory loss , neuropsychiatric disturbances, complex parital seizures visual hallucinations and myoclonus and responded to steroids. A negative microbiological screen of the CSF and serum along with raised CSF protein, elevated serum antithyroid antibodies, characteristic EEG and neuroimaging findings yielded the diagnosis

Analysis of Clinical, Biochemical and Pathologic Factors According to the Response to Initial Steroid Therapy in Active Crohn's Disease / 대한소화기내시경학회지

BACKGROUND/AIMS: The predictory factors of the response to initial steroid therapy in active Crohn's disease has been controversial in numerous literature reviews. We evaluated any predictory factor of the response to initial steroid therapy in active Crohn's disease patients. METHODS: The medical records of 32 patients with active Crohn's disease who clinically responded to oral steroid therapy were retrospectively reviewed. The steroid responsive group was defined as the one showing maintenance of response for more than one month from steroid withdrawal and the steroid dependent group as the one showing relapse or exacerbation during steroid tapering or within 30 days from steroid withdrawal. The clinical, biochemical, and pathologic factors were evaluated. RESULTS: There were 22 male and 10 female patients. The mean age was 28.9 years. The number of steroid responsive and dependent group was 22 (68.8%) and 10 (31.2%), respectively. There were no significant differences between these two groups in age, sex, time to diagnosis, perianal lesion, extent of disease, extraintestinal manifestations, presence of granuloma, presenting features, hemoglobin, ESR, and CRP, except serum albumin level. CONCLUSIONS: Serum albumin level was significantly lower in steroid dependent group than steroid responsive group, reflecting severe inflammation in steroid dependent group.