Subject(s)
Anemia, Aplastic/drug therapy , Antibodies, Monoclonal/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy , Aged , Anemia, Aplastic/chemically induced , Antibodies, Monoclonal, Murine-Derived , Cyclophosphamide/administration & dosage , Female , Humans , Leukemia, Lymphocytic, Chronic, B-Cell/complications , Rituximab , Vidarabine/administration & dosage , Vidarabine/analogs & derivativesABSTRACT
We report a case of visceral leishmaniasis in a patient receiving steroids and cyclophosphamide for polyarteritis nodosa. The clinical presentation of leishmaniasis, with fever, pancitopenia and hypergammaglobulinemia may be confused with a reactivation of vasculitis or with other non-infectious conditions such as haematologic diseases. In endemic areas, the case of latent leishmaniasis must be considered and serology for Leishmania should be performed before starting immunosuppressive treatment.
Subject(s)
Leishmaniasis, Visceral/complications , Polyarteritis Nodosa/complications , Polyarteritis Nodosa/drug therapy , Steroids/adverse effects , Antirheumatic Agents/adverse effects , Cyclophosphamide/adverse effects , Humans , Male , Middle AgedABSTRACT
Polyarteritis nodosa is a necrotising vasculitis of small and medium-sized arteries. All coats of these vessels are involved easily resulting in aneurysm formations. It is an immunologic disease owing to immune complexes deposits. Kidney affection is over 80%. Polyarteritis nodosa may be complicated by perirenal hematoma, hemobilia, intrahepatic hemorrhage, epidural hematoma. Spontaneous perirenal hematoma can be the initial manifestation of this disease. Abdominal ultrasonography can provide a quick diagnosis of complicating disease and embolization by interventional radiology may be considered a therapeutic alternative to surgery.
Subject(s)
Hemorrhage/etiology , Kidney Diseases/etiology , Polyarteritis Nodosa/complications , Diagnosis, Differential , Humans , Male , Middle Aged , Polyarteritis Nodosa/diagnosisABSTRACT
It has been widely claimed that phantom limbs are not experienced by children born without the part or who have it amputated in early childhood. This review looks at some reported cases of such phantoms, as well as a lesser known account that shows that phantoms of aplasics can be vivid and dexterous. Reasons for the infrequency of such reports are examined, and some implications for understanding the development of the body schema are proposed.
Subject(s)
Ectromelia/psychology , Phantom Limb/psychology , Awareness , Body Image , Child , HumansABSTRACT
Phlebotomy is generally thought to be contraindicated in porphyria cutanea tarda (PTC) associated with hemodialysis for the anemia which is often present in uremic patients. We report a patient with a severe form of hemodialysis-related PTC and biochemical parameters suggestive of iron overload in whom treatment with small repeated phlebotomies was well tolerated without any significant worsening of the anemia and gave marked biochemical improvement and complete clinical remission.
Subject(s)
Bloodletting , Porphyrias/therapy , Renal Dialysis/adverse effects , Skin Diseases/therapy , Aged , Female , Humans , Porphyrias/etiology , Porphyrins/blood , Skin Diseases/etiologyABSTRACT
The authors measured the presurgical serum levels of some tumor associated antigens in 36 patients bearing primitive ovarian carcinoma and in 284 controls. Ca125, which has shown a sensitivity (SE) of 63.8% and a specificity (SP) of 92.6%, was elevated especially in serous and undifferentiated carcinomas, while Ca19-9 (SE = 33.3% and SP = 89.7%) and CEA (SE = 19.4% and SP = 96.4%) were more often pathological in mucinous ones. TPA (SE = 75.0% and SP = 81.3%) had no particular correlation with any histotype. Parallel assessment of Ca125 and Ca19-9 showed a SE = 83.3% and a SP = 83.8%. In patients with epithelial ovarian cancer, the circulating concentrations of tumor markers were periodically measured during and after chemotherapy. Ca125 levels correlated with the course of disease in 87.1% of instances, while Ca19-9 ones correlated in 72.2% and TPA ones in 78.6%. Constantly high concentrations of one or more markers during chemotherapy are indicative for unresponsiveness of cancer to cytostatic drugs. Serum levels of one or more tumor antigens elevated at diagnosis and in the normal range at the end of primary treatment can be associated both with a pathological complete regression and with a persistence of neoplastic disease at second look laparotomy. Considering the different sensitivity of every single marker in carcinomas of different histotype, the combined evaluation of multiple tumor associated antigens seems to offer the best information in the monitoring of epithelial ovarian cancer.
Subject(s)
Antigens, Neoplasm/analysis , Ovarian Neoplasms/immunology , Adult , Aged , Aged, 80 and over , Antigens, Tumor-Associated, Carbohydrate , Carcinoembryonic Antigen/analysis , Combined Modality Therapy , Female , Genital Diseases, Female/immunology , Humans , Middle Aged , Neoplasm Staging , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , Peptides/analysis , Tissue Polypeptide AntigenABSTRACT
A case of human placental lactogen (hPL) deficiency together with normal oestriol levels associated with a normal pregnancy in a woman in her second pregnancy is reported. The woman gave birth to a healthy male infant. The placenta was normal. Extremely low hPL levels may be compatible with the delivery of a healthy infant.
