ABSTRACT
A case of idiopathic myelofibrosis presenting with a pleural effusion secondary to extramedullary haemopoeisis is described. Approximately 2 years following the diagnosis of his myeloprolioferative disorder the patient presented with dyspnoea. Physical signs were consistent with a pleural effusion which was confirmed radiologically. Cytology of the effusion fluid demonstrated myeloid precursors, including megakaryocytes. The effusion required repeated draining and a pleurodesis was undertaken in an attempt to prevent reaccumulation of the fluid. The procedure was successful and follow up over a period of 5 months demonstrated no recurrence of the pleural effusion on that side of the chest. An effusion later occurred on the other side but was managed conservatively by drainage. Hydroxyurea was introduced at that stage, but shortly afterwards the patient died from an unrelated cause. We review the literature on this uncommon complication of myelofibrosis and discuss the options available to treat the disorder.
Subject(s)
Hematopoiesis, Extramedullary , Hydroxyurea/therapeutic use , Pleural Effusion/etiology , Pleurodesis , Primary Myelofibrosis/therapy , Humans , Male , Middle Aged , Primary Myelofibrosis/etiologyABSTRACT
A case of severe Sweet's syndrome associated with myelodysplasia is reported. The skin lesions responded to high doses of systemic steroids, but recurred rapidly on dose reduction. Treatment with a low dose of cyclosporin resulted in sustained clearance of the skin lesions, and was associated with a stable haemoglobin level, without the need for further blood transfusions.
Subject(s)
Cyclosporins/therapeutic use , Myelodysplastic Syndromes/complications , Sweet Syndrome/complications , Humans , Male , Middle Aged , Myelodysplastic Syndromes/drug therapy , Sweet Syndrome/drug therapyABSTRACT
Eating disorders are associated with a wide range of physical symptoms and signs and with aberrant laboratory findings. The frequency of haematological and immunological abnormalities reflects the key role of adequate nutrition in the maintenance of normal bone marrow and immune function. The nature of these abnormalities and their clinical implications are discussed here.
Subject(s)
Feeding and Eating Disorders/complications , Hematologic Diseases/etiology , Immune System Diseases/etiology , Bone Marrow Examination , Feeding and Eating Disorders/classification , Feeding and Eating Disorders/diagnosis , Hematologic Diseases/blood , Hematologic Diseases/prevention & control , Humans , Immune System Diseases/blood , Immune System Diseases/prevention & control , Nutritional StatusABSTRACT
A review of data on haemolytic disease of the newborn (HDN) collected in Newcastle upon Tyne over 25 years revealed 194 pregnancies in which anti-Kell was the only antibody detected. Sixteen affected babies were born. None was hydropic, three had very severe disease but all survived. There were also three stillbirths, none of which had post-mortem appearances of HDN. The highest recorded anti-Kell titres in individual patients ranged from 1/1 to 1/2048 and bore no relation to the severity of the disease. Of the eight pregnancies in which amniotic fluid examination predicted a high risk of stillbirth, half resulted in unaffected babies. We suggest that haemolytic disease caused by anti-Kell is less severe than suggested by some workers. The use of guidelines developed from the study of Rhesus disease to determine the need for intervention in women with anti-Kell may be inappropriate.
