RESUMO
Neonatal alloimmune thrombocytopenia (NAIT) is a complex condition, stemming from the transplacental passage of alloantibodies from a pregnant mother directed against fetal platelet antigens. This case report discusses a rare instance of severe NAIT initially presenting as inadequate weight gain. After a clinical workup yielded negative findings for an infection and the resolution of the patient's thrombocytopenia following the administration of platelet products and intravenous immunoglobulin (IVIG), hematology deduced that this patient's NAIT was secondary to maternal history of gestational pemphigus. We describe the pathophysiology and current understanding of NAIT, pemphigoid gestationis (PG), as well as an analysis of their association. This intersection of NAIT and maternal PG underscores the importance of considering potential interactions between maternal autoimmune conditions overall and their impact on fetal health.
RESUMO
Renal cell carcinoma (RCC) is the most common type of kidney cancer. It typically presents with macroscopic hematuria, weight loss, and or a palpable flank mass. Diagnosis of this disease involves imaging techniques such as abdominal ultrasound and CT scans. Care for RCC can consist of ablation, tumor removal, nephrectomy, and systemic treatment options. Herein, we present a case of a 50-year-old Hispanic male with complaints of rectal bleeding and hematuria. Prior to admission, the patient had been informed twice about high suspicion of renal malignancy. Due to low health literacy and barriers to communication, he failed to understand the magnitude of his diagnosis. Subsequently, he underwent a resection of a considerable 22 cm x 13 cm x 13 cm RCC of his left kidney. This case highlights the need for effective patient health education to prevent emotional distress in patients with low health literacy.
RESUMO
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated condition caused by the production of maternal antibodies to fetal red blood cells. This condition most commonly arises due to Rh factor incompatibility. The case presented here displays an example of HDFN in which the mother and fetus's blood type was O+. Upon further investigation, it was determined that the mother is a producer of anti-Gonzales antibodies (anti-Go(a)). With no cases published in the 21st century, this antibody is a rare cause of HDFN. Anti-Go(a) is produced against the Go antigen, a low-frequency Rh antigen found predominantly in African and Puerto Rican populations. Bringing awareness to this rare cause of HDFN may accelerate diagnosis when the physician is faced with non-ABO and non-Rh isoimmunization in these ethnic groups.
