RESUMO
Vancomycin induced thrombocytopenia (VIT) is an uncommon side effect of vancomycin which can manifest from mild petechiae to life-threatening bleed. Decreased renal clearance of vancomycin results in prolonged thrombocytopenia by antibody-mediated platelet destruction in the presence of vancomycin. Improvement in thrombocytopenia is achieved with the elimination of vancomycin. We describe a patient with end stage renal disease who experienced a protracted course of thrombocytopenia from vancomycin. We illustrate the mechanism of thrombocytopenia and the treatment modalities used by us and those described in literature. VIT is an important differential in patients with thrombocytopenia admitted to the hospital.
RESUMO
Patients with grade IV astrocytoma or glioblastoma multiforme (GBM) have a median survival of <12â months, increased to 14.6â months by maximal safe resection with radiation and temozolamide. In the absence of chemotherapy, radiotherapy or chemoradiotherapy, spontaneous regression of GBM or regression while only being on dexamethasone (DEX) and levetiracetam (LEV) have seldom been reported. Here, we present a case of a patient who had significant regression of the GBM with DEX and LEV alone. In this study, we hypothesise a plausible antineoplastic role of DEX and or LEV in GBM and highlight molecular, preclinical and clinical studies supporting this role.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Glioblastoma/tratamento farmacológico , Segunda Neoplasia Primária/tratamento farmacológico , Astrocitoma/radioterapia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/radioterapia , Transtornos Cognitivos/tratamento farmacológico , Dacarbazina/administração & dosagem , Dacarbazina/análogos & derivados , Dexametasona/administração & dosagem , Glioblastoma/diagnóstico , Humanos , Levetiracetam , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Regressão Neoplásica Espontânea , Segunda Neoplasia Primária/diagnóstico , Piracetam/administração & dosagem , Piracetam/análogos & derivados , TemozolomidaRESUMO
Sickle cell anaemia coexisting with gout is a rare clinical association, as is gout and eosinophilia. This report records the second case of chronic tophaceous deposits in Sickle cell anaemia. The patient also had eosinophilia in association with gout. Skeletal fluorosis was an incidental finding in this patient. Treatment with packed cell transfusions, hydroxyurea and colchicine lead to the resolution of anaemia and symptoms of acute gout.