Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bone Marrow Transplantation , Combined Modality Therapy , Humans , Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology , Prognosis , Regression Analysis , Remission Induction , Risk FactorsSubject(s)
Anthraquinones/therapeutic use , Multiple Myeloma/drug therapy , Adult , Aged , Anthraquinones/administration & dosage , Anthraquinones/adverse effects , Drug Administration Schedule , Female , Hematologic Diseases/chemically induced , Humans , Lymphoma/drug therapy , Male , Middle Aged , MitoxantroneABSTRACT
A 34-year old man presented with jaundice, nausea and vomiting. He had previously been in good health but was a chronic drug abuser and regularly consumed large amounts of wine. Emphysematous cholecystitis was diagnosed by abdominal radiography. Examination of the peripheral blood smear, blood count and serum chemistries revealed a microangiopathic hemolytic anemia, thrombocytopenia and renal insufficiency. He was treated with antibiotics and intravenous fluids and had clinical, hematologic and biochemical improvement over the course of the next four weeks. At surgery, a chronically inflamed gallbladder, containing multiple stones, was resected. There was no evidence of vasculitis. Although emphysematous cholecystitis associated with hemolytic-uremic syndrome is most unusual, other diseases of infectious etiology have been reported in association with the hemolytic-uremic syndrome. The possible etiologic role of endotoxin is discussed, as are the importance of recognizing the hemolytic-uremic syndrome in patients with underlying or concurrent bacterial infections and the problem of management in such a case.