ABSTRACT
Chronic myelogenous leukaemia is a disease in which bone marrow produces too many white blood cells. It is more common in middle age and its incidence is rare in children. Imatinib is the standard first-line treatment in chronic myeloid leukaemia. It improved the prognosis with lesser side effects. Our point of interest is to highlight its role in the paediatric age group. we present case series of a patient with chronic myeloid leukaemia responsive to imatinib. Because of the rare incidence of chronic myeloid leukaemia in this age room limited studies to explore the role of treatment modalities in the paeds group. Our case series highlights imatinib's effectiveness in treatment and improving the prognosis of the disease in this age group.
Subject(s)
Antineoplastic Agents , Imatinib Mesylate , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Adolescent , Child , Humans , Antineoplastic Agents/therapeutic use , Imatinib Mesylate/therapeutic use , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy , Pakistan , Prognosis , Treatment OutcomeABSTRACT
Chronic myeloid leukaemia is a myeloproliferative stem cell disorder characterized by dysregulated production and proliferation of myeloid cells. Hallmark of the disease is the reciprocal translocation between chromosome 9 and 22 giving rise to an abnormal chromosome known as Philadelphia chromosome. Approximately 15% of all leukaemias are chronic myeloid leukaemia with a slight male predominance. This is a case of a 14-year-old boy with no premorbid presented with 4 months history of fatigue and shortness of breath on exertion. On examination patient was vitally stable. On general physical examination there was pallor and sternal tenderness. On abdominal examination spleen was palpable with a size of about 8cm. Respiratory, cardiovascular and musculoskeletal examination was unremarkable. Complete blood picture showed leukocytosis, low haemoglobin and normal platelets. Erythrocyte sedimentation rate was 65 mm/hr. Liver function tests, Renal function tests, Serum electrolytes, Urine routine examination and c-reactive protein were normal. Chest x-ray and Electrocardiography was normal. Peripheral blood smear showed neutrophils 56% with 3% lymphocytes, 1% blasts and retic count of 0.5%. Bone marrow biopsy was suggestive of chronic myeloid leukaemia which was confirmed by FISH and Cytogenetic studies.
Subject(s)
Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Male , Female , Humans , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics , Translocation, Genetic , Chromosome Aberrations , Bone Marrow , Leukocytosis/geneticsABSTRACT
INTRODUCTION: Purple Urine Bag Syndrome (PUBS) is purple discoloration of urine and is common in bedridden patients with long-term urinary catheter. Although typically benign, the purple discoloration is alarming to both the patients and their attendants. CASE REPORT: This case report presents an uncommon case of PUBS in a 74-year-old lady with hypertension, type II diabetes and ischemic stroke from last 2 years. She has neurogenic bladder and has been catheterized from last 2 years. Her last catheter was changed 15 days back. She presented to the emergency room with complaints of change in color of urine with low grade fever from last 1 week. on clinical examination there was one bed sore on lumbar region that was grade 1 with pus oozing from base of ulcer. CLINICAL DISCUSSION: PUBS is generally associated with alkaline urine and in patients who was chronically catheterized as was observed in this patient, although it has also been reported in acidic urine. CONCLUSION: PUBS is a rare manifestation of urinary tract infection with an alarming appearance and can be a source of anxiety for patients and their families. Being asymptomatic and comparatively benign, purple discoloration is simply an indicator of underlying bacteriuria and is of no prognostic value.
