ABSTRACT
INTRODUCTION: The aim of this study was to assess diabetic retinopathy progression during pregnancy and to determine the predictive factors of this progression. PATIENTS AND METHODS: Monocentric retrospective study including 77 consecutive diabetic women submitted to a multidisciplinary medical follow-up during pregnancy with at least one ophthalmologic examination per trimester with ocular fundus photographs. RESULTS: Diabetic retinopathy was evidenced in 21 (27.3%) of the patients during the first trimester (no proliferative form), in 22 women (28.6%) during the second (two proliferative forms), and 24 (31.2%) during the third (two proliferative forms). Progression of at least 1 grade was evidenced in four patients from the first to the second trimester, in three from the second to the third, and finally in seven patients during the overall follow-up period. Two patients showed progression to a proliferative form from the first to the second quarter. We failed to identify any predictive factor of diabetic retinopathy progression except when combining prior systemic hypertension and pregnancy-induced hypertension (p<0.03). CONCLUSION: The results of our study confirm that diabetic retinopathy progression is uncommon during pregnancy, especially if diabetic retinopathy is absent or mild at the beginning. Optimal blood sugar levels and blood pressure check-ups play a major role in preventing diabetic retinopathy progression. Collaborative medical follow-up can minimize ophthalmologic impairment during pregnancy.
Subject(s)
Diabetic Retinopathy/diagnosis , Pregnancy in Diabetics/diagnosis , Adolescent , Adult , Disease Progression , Female , Humans , Pregnancy , Retrospective Studies , Young AdultSubject(s)
Anemia, Hemolytic, Autoimmune/immunology , Antigens, CD/genetics , Autoantibodies/blood , Erythrocytes/immunology , Receptors, IgG/genetics , Waldenstrom Macroglobulinemia/genetics , Waldenstrom Macroglobulinemia/immunology , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Female , Follow-Up Studies , Genotype , Humans , Immunoglobulin G/blood , Male , Middle Aged , Polymorphism, Genetic , Survival Rate , Treatment Outcome , Waldenstrom Macroglobulinemia/drug therapyABSTRACT
As in other hematological malignancies, the achievement of a complete remission (CR) is important in multiple myeloma but is still based on common cytological and electrophoretic criteria. In this report, we studied 14 patients who achieved an apparent CR following high-dose therapy using fluorescence in situ hybridization (FISH) analysis. Although the results were difficult to interpret in two patients, 12 of 14 patients had unequivocal persistence of abnormal plasma cells in their bone marrow. Our results suggest that only a few patients, if any, are in true CR following one course of high-dose therapy and are in favor of post-transplantation treatments.