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Spatial Distribution and Preventive Behaviours Towards Human Brucellosis in an Endemic Area: A PEN-3 Model-Based Case-Control Study.

INTRODUCTION: Brucellosis is a bacterial zoonotic disease transmitted through contact with infected animals or unpasteurized products. Endemic in Iran, it causes fever, fatigue and muscle pain, posing significant public health and economic challenges. This study aims to investigate the factors influencing preventive behaviours against brucellosis in Hamadan Province, utilizing the PEN-3 model to explore cultural and social dynamics, alongside Geographic Information System (GIS) technology for spatial analysis of disease incidence. METHODS: This study was conducted in two sequential phases. In

A single dose of Sn-mesoporphyrin prevents development of severe hyperbilirubinemia in glucose-6-phosphate dehydrogenase-deficient newborns.

OBJECTIVES: Severe neonatal jaundice is a common clinical manifestation of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and the most difficult to manage; kernicterus is not an uncommon outcome. We assessed in healthy, direct Coombs test-negative Greek newborns of >/=38 weeks' gestational age 1) the current burden of G-6-PD deficiency-associated severe jaundice, and 2) the efficacy of preventive use of Sn-mesoporphyrin (SnMP), a potent inhibitor of heme oxygenase activity and thus of bilirubin production, in ameliorating jaundice in G-6-PD-deficient neonates. METHODS: The studies were…

Daratumumab: Therapeutic asset, biological trap!

OBJECTIVES: Recently, daratumumab has been included in the therapeutic strategies for myeloma patients. This molecule is an antibody directed against CD38, strongly expressed on plasma cells. Nevertheless, as CD38 is also present on erythrocyte membrane, daratumumab interferes with immunohaematological tests, complicating the selection of compatible blood. METHODS: A total of 14 patients treated by daratumumab have been followed in our transfusion laboratory. Among them, 11 have been transfused. Dithiotreitol (DTT) has been used to inhibit the daratumumab's interference, in the pre-transfusio

Mixed-type autoimmune haemolytic anaemia: unusual cases and a case associated with splenic T-cell angioimmunoblastic non-Hodgkin's lymphoma.

The diagnosis of mixed-type autoimmune haemolytic anaemia (AIHA) is based on demonstrating the presence of "warm" IgG auto-antibody and "low titre" ( < 64 at 4 degrees C), "high thermal amplitude" (reacting at or >30 degrees C) "cold" IgM auto-antibody. Mixed-type AIHA is uncommon. Red cell agglutination on the peripheral blood film is a common finding in mixed-type AIHA and can lead, initially, to a mis-diagnosis of cold haemmagglutinin disease (CHAD). Mixed-type AIHA is rare and can be idiopathic or secondary, often associated with systemic lupus erythematosus (SLE) and lymphoma. In general,

Klinefelter's syndrome presenting with leg ulcers.

A 54-year-old man of Persian origin presented to our department with a 1-year history of ulcers on the right leg that had been unresponsive to numerous topical treatments, accompanied by lymphedema of the right leg. Medical history included hypergonadotropic hypogonadism, which had not been further investigated. He was treated for 20 years with testosterone IM once monthly, which he stopped a year before the current hospitalization for unclear reasons. The patient reported no congenital lymphedema. Physical examination revealed two deep skin ulcers (Figure 1) on the right leg measuring 10 cm i

[A Case of Simultaneous Acute Lymphoblastic Leukemia Diagnosis with Crimean-Congo Hemorrhagic Fever].

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease that can be presented with fever, fatigue, generalized joint/body pain, diarrhea and bleeding in various parts of the body. The risk of developing a severe fatal disease in humans, the possibility of being infected with aerosols and the risk of being used as a biological weapon make the disease still an important health problem all over the world as there is no a specific treatment and vaccine that has proven effective againt the virus today. The pathogenesis of the disease is not known, but vascular endothelial damage is prominent.

Роль ДИОТРЕИТОЛ в разрешении предтрансмиссии иммуногематологии у пациентов, получающих anti-CD38 Моноклональные антитела для лечения множественной миеломы.

ВВЕДЕНИЕ: Daratumumab (Darzalex; Janssen-Cilag Pty Ltd), a/ anti-CD38 Моноклональная антитела (MoAb) продемонстрировала высокую эффективность в лечении рецидива и рефрактной множественной миеломы (MM). Она стоит как пионер anti-CD38 Минздрав, утвержденный Управлением лесного хозяйства США (УЛХ)2015) и GGA Australia (Australia)2017). Направляя CD38 на клетки миэломы, Daratumumab создает проблему в проведении предтрансфузионных испытаний, вызывая панреактивность при косвенных тестах на антиглобулин (ИАТ) из-за выражения CD38 на красных клетках. В этом исследовании изучается роль ДИОТРЕИТОЛ (ДТТ)

Thrombotic microangiopathy following chimeric antigen receptor T-cell therapy.

INTRODUCTION: Thrombotic microangiopathy (TMA) is characterized by microangiopathic hemolytic anemia and is associated with a variety of conditions and following hematopoietic stem cell transplantation. Chimeric antigen receptor T-cell (CAR-T) therapy is a novel immunotherapeutic approach using genetically modified autologous T cells. CAR-T therapy has been linked with injuries to vascular endothelium, but a direct association between CAR-T and TMA has not been reported. CASE REPORTS: Two cases of TMAs following CAR-T treatment are reported here. In each case, clinical evidence of kidney inju

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… Direct antiglobulin (Coombs) test was negative thereby excluding autoimmune hemolytic anemia. Coagulation assays were found to be normal. Folate, B12, and methylmalonic acid levels were all within normal ranges. Autoimmune testing panels (ANA, ANCA) were unremarkable. … O-TMA [ 7 ] CTN-TMA [ 5 ] IWG-TMA [ 6 ] Normal coagulation assays a Yes Yes Yes Schistocytosis ≥ 2/HPF ≥ 2/HPF ≥ 8/HPF Increase in serum LDH Yes Yes Yes Concurrent renal b and/or neurologic dysfunction without other explanations Yes Negative Coombs test Yes Yes Thrombocytopenia c Yes Yes Decrease in …

От костной боли до тяжелых реналовых симптомов: Путешествие пациента с множественной миеломой и Брюселлозом (деловой отчет).

В эндемических районах заметный рост серологовых титер Брюселлы с динамичным спадом после лечения поддерживает настоящую инфекцию даже в присутствии моноклональной гаммопатии. Для того чтобы избежать диагностических задержек и оптимизировать управление пациентами, следует рассматривать сопутствующие инфекционные и злокачественные процессы у пациентов с острой почечной недостаточностью и переплетающимися системными симптомами.

Hematology and Immune-Related Disorders

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Atypical Hemolytic Uremic Syndrome in the Setting of Acute Clostridium difficile Colitis.

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. HUS can be secondary to multiple etiologies such as infections, medications, and immune processes. A rare, yet significant, etiology of HUS includes acute Clostridium difficile colitis. Here, we present a case of atypical HUS secondary to acute C. difficile colitis, successfully treated with hemodialysis and systemic corticosteroids. It is imperative that clinicians are cognizant of C. difficile-associated HUS given the overall rising incidence of acute C. difficile

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… Coombs test was negative as well. Peripheral blood smear was reviewed and showed schistocytes (Figure 1 ). Based on these pertinent findings, a diagnosis of HUS was established. Figure 1 Peripheral blood smear revealing schistocytes (blue arrows). … Microangiopathic hemolytic anemia is defined by a hemoglobin level less than 10 g/dL with a negative Coombs test and a peripheral blood smear demonstrating schistocytes (up to 10% of red cells) and helmet cells [ 1 ]. Thrombocytopenia is characterized by a platelet count below 140,000/mm 3 . …

Необычный случай тромбоцитопенсии и ренального провала, возрождающего злодеяние - ассоциированная тромботическая микроангиопатия.

Тромботическая микроангиопатия (TMA) — процесс, характеризующийся тромбоцитопенией, микроангиопатичной гемолитической анемией и конечной травмой. ТМА, связанная с злоумышленностью, встречается редко и может быть похожа на первичные синдромы ТМА, особенно в тех случаях, когда преобладает почечная дисфункция, а периферийные мазки ограничены. Мы представляем случай биопсии, подтвержденной почечной ТМА, при установлении недавно диагностированной метастатической скучной клеточной карциномы (SCC) после значительной диагностической неопределенности. 59-летний мужчина с сахарным диабетом, зависящим от

Коллапсирование гломерулопатии в пациенте с малярией и множественной миеломой: доклад по делу.

Коллапсирование гломерулопатии представляет собой серьезную форму сегментального гломерулосклероза (FSGS), который может иметь место в качестве первичного или вторичного заболевания, зачастую в контексте таких инфекций, как ВИЧ. Множественная миэлома может вызывать травму почек с помощью таких механизмов, как нефропатия, в то время как травмы почек, связанные с малярией, чаще всего вызваны острым некрозом трубки. Мы представляем пример 47-летнего мужчины африканского происхождения с хорошо контролируемой ВИЧ-инфекцией, который сильно заболел АКИ и нуждался в интенсивной терапии и почечной тера

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… However, the positive Coombs test and lack of fragmentocytes excluded this diagnosis. Given the patient’s travel history, malaria was considered, and a blood smear confirmed Plasmodium falciparum infection. …

RSK inhibitor BI-D1870 inhibits acute myeloid leukemia cell proliferation by targeting mitotic exit.

The 90 kDa Ribosomal S6 Kinase (RSK) drives cell proliferation and survival in cancers, although its oncogenic mechanism has not been well characterized. Phosphorylated level of RSK (T573) was increased in acute myeloid leukemia (AML) patients and associated with poor survival. To examine the role of RSK in AML, we analyzed apoptosis and the cell cycle profile following treatment with BI-D1870, a potent inhibitor of RSK. BI-D1870 treatment increased the G2/M population and induced apoptosis in AML cell lines and patient AML cells. Characterization of mitotic phases showed that the metaphase/an

Hematology

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… Rectal examination for occult blood Investigations BASIC labs —CBCD, peripheral smear, reticulocyte count, iron, ferritin, TIBC, % sat, Cr, TSH, AST, ALT, ALP, bilirubin, INR, PTT, haptoglobin, LDH, direct and indirect Coombs test, serum protein electrophoresis, fecal occult blood SPECIAL urine … TEST direct coombs test (DAT)—patient’s washed RBC incubated with anti-IgG and anti-C3. …

Frequency and causes of anemia in Lymphoma patients.

ObjectivePurpose of this study was to find out frequency of anemia and its causes in newly diagnosed treatment naive lymphoma patients.MethodsWe retrospectively studied all lymphoma patients (> 18 years age) diagnosed and treated at Shaukat Khanum Memorial Cancer Hospital and Research Centre, from January 2016 till January 2017. The data was collected from electronic Hospital Information System. Descriptive statistics were done by using summary measures for categorical variables as well as continuous variables.ResultsOut of a total 408 patients, 272 were males and 136 females. Median age of pa

Microangiopathy in multiple myeloma: a case of carfilzomib-induced secondary thrombotic microangiopathy successfully treated with plasma exchange and complement inhibition.

BACKGROUND: Thrombotic microangiopathy (TMA) is a potentially organ and life-threatening condition affecting patients with multiple myeloma (MM). Cases of proteasome inhibitor-induced TMA and specifically carfilzomib-induced TMA have been rarely reported and standards for diagnostic workup and treatment are not available. CASE PRESENTATION: We describe a case of a male MM patient under salvage therapy including proteasome inhibitor carfilzomib following chemotherapy and autologous stem cell transplantation. The patient then developed acute kidney injury with clinical and laboratory signs of T

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… Indirect Coombs test showed positive results without antibody specificity probably due to recent treatment with isatuximab. After treatment of patient blood with dithiothretiol, an inhibitor of isatuximab erythrocyte binding, Coombs testing was negative indicating non-immunohemolytic hemolysis. …

Poster Abstracts

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… PP 2: Thematic Area: Immunohematology: A case of autoimmune hemolytic anemia with positive direct coombs test in a pediatric patient at RIMS Imphal Eppili Shasi Bhusan Rao, Pratima Kh Regional Institute of Medical Sciences, Imphal, Manipur, India Background: A 10-year-old female presented with a 10 … A Direct Coombs Test (DCT) was ordered on 20.02.25. Laboratory findings revealed: Hemoglobin: 7.2 g/dL Hematocrit: 17.8% Platelet count: 30,000/μL. Peripheral smear showed -moderate anisocytosis, microcytic hypochromic cells with polychromasia, macrocytes, and occasional nucleated RBCs. …