ABSTRACT
Antibodies directed against platelet-surface antigen cause immune thrombocytopenia. Transplantation from a donor with immune thrombocytopenia has rarely been reported in the literature and never with a platelet count of 1 × 10(9)/L. We report one liver transplant recipient and one kidney transplant recipient who received organs from a donor with immune thrombocytopenia dying from intracranial hemorrhage. The kidney recipient showed no evidence of thrombocytopenia after transplantation. However, in the liver recipient, the platelet count nadired at 4 × 10(9)/L and normalized within 3 months. Transplantation of a liver from a donor suffering from immune thrombocytopenia must be considered with great caution. Other organs are suitable for transplantation; however, recipients of these organs must be followed carefully for evidence of immune thrombocytopenia and treatment offered accordingly.
Subject(s)
Kidney Transplantation , Liver Transplantation , Thrombocytopenia/surgery , Aged , Humans , Thrombocytopenia/immunology , Thrombocytopenia/physiopathology , Treatment OutcomeABSTRACT
Depression is the main psychiatric symptom in patients living with HIV. Genetic predisposition, stress from disease as well as the antiretroviral therapy itself are discussed as pathogenic factors. We report a 35-year-old HIV-positive man suffering from bipolar disorder who developed major depression shortly after commercing combination antiretroviral therapy (cART) on three occasions. The first two times the patient ceased therapy autonomously, and the depression disappeared completely. The close connection between cART and major depression in the present case supports the depression-inducing potential of cART. Additionally, we present an overview of literature.
Subject(s)
Anti-HIV Agents/adverse effects , Depression/chemically induced , Depression/virology , HIV Infections/drug therapy , HIV Infections/psychology , Adult , Anti-HIV Agents/therapeutic use , Bipolar Disorder/chemically induced , Bipolar Disorder/virology , Humans , Male , Medication AdherenceABSTRACT
Results of radioiodine therapy (131/125) of hyperthyroidism are reported. The individually calculated doses of 131-iodine were: 6000 rad in cases of small (not more than 60 g) diffuse goiters, 8000-10000 rad in large diffuse goiters, 10000-12000 rad in nodular goiter and 30000-40000 rad in autonomous adenoma. In about 75% of the patients a single application of 131-iodine was sufficient to control the hyperfunction. The cumulative risk of myxedema ten years after therapy was: 31% in small diffe goiters, 12% in large diffuse goiters and 6% in nodular goiter. All cases considered together, the cumulative myxedema risk was about 12%. This figure compares favourably with the results of surgical treatment and they document the necessity of individual calculation of the dose in order to get optimal results. 125-iodine was applied since October 1972 in cases of small diffuse goiters. The dose was standardized according to the gland weight, uptake and effective half value time (dose at the colloid-cell interface 12000-15000 rad). 5-12 months thereafter, there were about 60% of the patients euthyroid. The genetic and somatic risk of radiation is considered quantitatively and we conclude that there is no real argument aginst radioiodine therapy of hyperthyroidism except in children and in youth. Risks and efficiency of other treatments (surgical, antithyroid drugs) are compared with the radioiodine treatment and it is concluded that radioiodine is to be preferred in the major part of the hyperthyroid patients.
