Assuntos
Anticorpos Monoclonais Humanizados/efeitos adversos , Antineoplásicos/efeitos adversos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Síndromes Mielodisplásicas/induzido quimicamente , Alemtuzumab , Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Humanos , Leucemia Linfocítica Crônica de Células B/patologia , Síndromes Mielodisplásicas/patologiaRESUMO
Acute tumor lysis syndrome (TLS) has been reported in hematological malignancies, such as aggressive non-Hodgkin's lymphoma, acute lymphoblastic leukemia, and rarely, in other malignancies (solid tumors) in association with the administration of cytotoxic therapy. We report a case of a patient with chronic lymphatic leukemia (CLL) who developed autoimmune hemolytic anemia treated by high dose corticosteroids and, following this treatment, developed acute tumor lysis syndrome. Only one similar case has been reported recently. Clinicians should be aware that corticosteroids alone may produce this potentially life-threatening complication.
Assuntos
Corticosteroides/administração & dosagem , Corticosteroides/efeitos adversos , Antineoplásicos/efeitos adversos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Síndrome de Lise Tumoral/etiologia , Doença Aguda , Idoso , Morte Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Feminino , HumanosRESUMO
We report on a patient with essential thrombocythemia treated with hydroxyurea who became febrile 3 weeks after the treatment was started. After drug withdrawal, the fever resolved but after rechallenge there was recurrence of the fever. Although hydroxyurea-induced fever is rare, this drug must be added to the list of drugs that produce fever and the physicians should be aware of this possibility.
Assuntos
Febre/induzido quimicamente , Hidroxiureia/efeitos adversos , Feminino , Humanos , Hidroxiureia/administração & dosagem , Pessoa de Meia-Idade , Trombocitemia Essencial/complicações , Trombocitemia Essencial/tratamento farmacológicoRESUMO
T cells and monocytes from patients with polycythemia vera (PV) were isolated and grown in culture. The conditioned medium was tested for the presence of soluble factors that promote proliferation of erythroid colonies from the blood of healthy donors. We show that T cells from all 14 PV patients that were examined secrete factor/s that stimulate the proliferation of erythroid burst-forming units (BFU-E) in the absence of an external source of erythropoietin and BPA. Addition of cyclosporin A to the culture did not inhibit the production of this activity. The conditioned medium from monocytes of PV patients can also stimulate normal BFU-E but to a much lesser extent than T-cell conditioned medium. Such stimulation was not observed with control T cells or monocytes. We observed that the fraction of DR-positive T cells was significantly higher in PV patients comparing to normal. These results suggest that PV patients possess an abnormally high level of circulating activated T cells which may in turn be the source of the putative factor that facilitates uncontrolled erythroid differentiation.
Assuntos
Fatores Estimuladores de Colônias/biossíntese , Células Precursoras Eritroides/citologia , Linfocinas/biossíntese , Policitemia Vera/sangue , Linfócitos T/metabolismo , Células Cultivadas , Fatores Estimuladores de Colônias/fisiologia , Humanos , Linfocinas/fisiologia , Monócitos/metabolismo , SolubilidadeRESUMO
The association between dermatomyositis and malignancy is well documented. However, the association between dermatomyositis and Hodgkin's disease is very unusual, particularly in children, adolescents, and young adults. A MEDLINE search of the literature revealed only 13 previous cases.
Assuntos
Dermatomiosite/diagnóstico , Doença de Hodgkin/diagnóstico , Adolescente , Dermatomiosite/complicações , Dermatomiosite/patologia , Diagnóstico Diferencial , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Humanos , MasculinoRESUMO
Involvement of the gastrointestinal tract in systemic lupus erythematosus is well documented but small intestinal malabsorption is a rare event. We report a 27 year old woman with systemic lupus erythematosus who had malabsorption and coeliac-like changes on intestinal biopsy. This is the eighth reported case of this association the significance of which is discussed.
Assuntos
Doença Celíaca/complicações , Lúpus Eritematoso Sistêmico/complicações , Adulto , Doença Celíaca/patologia , Feminino , Humanos , Jejuno/patologiaRESUMO
A case of an elderly man who developed severe hyponatremia and bone marrow granulomatosis while taking methyldopa is described. The hyponatremia was found to be due to the syndrome of inappropriate antidiuretic hormone secretion (SIADH). Bone marrow biopsy revealed granulomas. A MEDLINE search of the English literature was done, yielding only one previous report of methyldopa-induced bone marrow granulomatosis and no previous reports of methyldopa-induced SIADH.
Assuntos
Doenças da Medula Óssea/induzido quimicamente , Granuloma/induzido quimicamente , Síndrome de Secreção Inadequada de HAD/induzido quimicamente , Metildopa/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Medula Óssea/patologia , Doenças da Medula Óssea/patologia , Granuloma/patologia , Humanos , Hiponatremia/induzido quimicamente , MasculinoRESUMO
Pericardial effusion is an unusual complication of meningitis due to Neisseria meningitidis. Primary meningococcal pericarditis without signs of meningitis is rare. Only 18 cases have been described in the literature. The first case was reported in 1939 and the others since 1971. We report a case of primary meningococcal pericarditis in a pregnant woman. Improvement followed prompt antibiotic therapy. Fetal death necessitated abortion by curettage.
