ABSTRACT
Agranulocytosis is one of the most serious side effects to drugs. From January 1991 to June 1996 were diagnosed 19 cases of agranulocytosis associated with drugs at our hospital (incidence rate: 9.4 over million hab. per year). The average age was 62 and 11 cases were women. The drugs most commonly involved were metamizol and ticlopidine. In 15 of the patients fever blew up and 16 presented some infectious location. In 9 of the cases some positive microbiological culture was obtained, gram-negative bacilli being the commonest. G-CSF was used in 13 of the patients, observing a quicker haematological recovery (5.7 days vs 9.1, p = 0.07), though without any difference in mortality, which was of 0%. All this leads to the following conclusions: a high incidence of agranulocytosis in our environment and the important role of metamizol and ticlopidine in its origin.
Subject(s)
Agranulocytosis/chemically induced , Adult , Aged , Aged, 80 and over , Agranulocytosis/drug therapy , Dipyrone/adverse effects , Female , Granulocyte Colony-Stimulating Factor/therapeutic use , Humans , Male , Middle Aged , Ticlopidine/adverse effectsABSTRACT
We report two cases of hyperammonemic encephalopathy in patients with multiple myeloma. This rare complication, whose pathophysiology remains unknown, is associated with disease progression and so with a very bad prognosis. We believe that this complication should be included in the differential diagnosis of encephalopathy occurring in multiple myeloma.
Subject(s)
Ammonia/blood , Brain Diseases/blood , Brain Diseases/complications , Multiple Myeloma/complications , Delirium/etiology , Delirium/metabolism , Fatal Outcome , Female , Humans , Male , Middle Aged , Multiple Myeloma/pathology , Multiple Myeloma/physiopathologySubject(s)
Arthritis, Rheumatoid/drug therapy , Synovial Fluid/chemistry , Urokinase-Type Plasminogen Activator/administration & dosage , Adult , Aged , Arthritis, Rheumatoid/pathology , Female , Humans , Injections, Intra-Articular , Male , Middle Aged , Synovial Fluid/drug effects , Triamcinolone Acetonide/administration & dosageABSTRACT
Scedosporium prolificans is a filamentous fungus which has been recently identified as the aetiologic agent of severe infections in patients with haematological malignancies. Due to the resistance of S. prolificans to all known antifungals there are very few patients recovering from invasive infections. We describe the case of a patient with acute leukaemia who developed a S. prolificans pneumonia successfully treated with liposomal amphotericin B and who underwent autologous peripheral blood stem cells transplantation. The patient is in good health and has shown no evidence of reactivation of S. prolificans infection over one year after the transplant. Liposomal amphotericin B may be an effective treatment of pneumonia caused by S. prolificans in haematological patients.
