Результаты поиска

Pancytopenia Concurrent With Metabolic Encephalopathy.

Pancytopenia is a decrease in the number of cells in all peripheral blood cell lines and has been associated with anemias, cancers, chemotherapy, infections, and nutritional deficiencies. However, pancytopenia concurrent with encephalopathy is rare and not well-studied. We present a case of pancytopenia concurrent with metabolic encephalopathy. An 81-year-old female patient presented to the emergency department for two weeks of increased fatigue and hypersomnolence. The patient had trouble staying awake during the initial physical exam, and her laboratory results were significant for pancytope

Совпадение в полном тексте источника
… By day five, her laboratory results were notable for mildly elevated CRP (1.0 mg/dL) and ammonia (110 mcmol/L), parvovirus B19 immunoglobulin (Ig)G and IgM antibodies, CMV IgG antibody, slightly elevated MMA, and positive direct Coombs test. …

Roadmap for new practitioners to navigate the multiple myeloma landscape.

Multiple myeloma (MM) is a blood cancer in which monoclonal plasma cells cause end organ damage resulting in hypercalcemia, renal failure, anemia, and bone lesions. MM is considered incurable, however, recent advances in treatment have improved survival. Historically, MM has been treated with immunomodulatory drugs (IMiDs), proteosome inhibitors (PIs), and corticosteroids. While newer therapeutic approaches such as monoclonal antibodies and cellular therapies have broadened the treatment horizon, the selection and sequencing of these therapies has become more complex. This review aims to help

Pure red cell aplasia in a patient with rheumatoid arthritis after JAK inhibitor exposure-diagnostic challenges.

We describe a patient with long-standing rheumatoid arthritis (RA) who developed severe refractory transfusion-dependent anaemia lasting several months following treatment with a JAK1 inhibitor (Filgotinib). The patient proceeded with extensive investigations, including bone marrow assessment, and was initially diagnosed with Filgotinib-associated anaemia. However, despite stopping this agent, the anaemia persisted with fluctuating reticulocyte count resulting in multiple hospital admissions. Although the anaemia was initially attributed to Filgotinib, its persistence alongside delayed reticul

Renal Thrombotic Microangiopathy Associated with the Use of Bortezomib in a Patient with Multiple Myeloma.

Bortezomib is a first-generation proteasome inhibitor used in the treatment of multiple myeloma (MM). A few reports have linked bortezomib exposure with the development of thrombotic microangiopathy (TMA). We describe a case of biopsy-proven renal thrombotic microangiopathy associated with the use of bortezomib in a 51-year-old man with IgG lambda MM. To our knowledge, this is the first biopsy-proven case. In addition, reexposure to bortezomib 18 months later was associated with recurrence of TMA. This supports a possible causal role of bortezomib. The exact mechanisms remain to be elucidated.

Совпадение в полном тексте источника
… There was hypocomplementemia (C3 0.68 g/L, C3d 5.9%, and C4 0.14 g/L); cryoglobulins were absent; Coombs test, hepatitis B en C serology, ANF, and ANCA were negative. ADAMTS-13 activity was mildly reduced (34%). Genetic screening for complement mutations was negative. …

Infection related membranoproliferative glomerulonephritis secondary to anaplasmosis: A case report.

BACKGROUND: Anaplasmosis is a tick-borne disease with a range of clinical manifestations, from a flu-like illness with fever and myalgias to a severe systemic disease with multisystem organ failure. Although renal involvement is not a common presentation, there have been few cases reporting acute kidney injury from Anaplasmosis. CASE SUMMARY: We present a 55-year-old female with anaplasmosis who developed acute kidney injury due to membranoproliferative glomerulonephritis (MPGN). The patient originally presented with cough and shortness of breath. She was admitted to the hospital with a diagn

Совпадение в полном тексте источника
… The anemia evaluation revealed low haptoglobin, elevated lactate dehydrogenase, and a negative Coombs test. Peripheral blood smears lacked schistocytes but indicated that the patient had chronic normocytic anemia with elevated polychromasia in circulating nucleated erythrocytes. …

Aggressive systemic mastocytosis with multiple organ involvement: a case report.

Systemic mastocytosis is a rare malignancy whose main diagnostic finding is the abnormal proliferation of clonal mast cells. In this report, a 63-year-old woman is presented who was referred to the emergency department with lower back pain. Due to the hypereosinophilia in blood tests, a bone marrow biopsy was performed, and except for the presence of a large number of mastocytes, no other pathologic findings were seen. Furthermore, the immunohistochemistry test showed positive CD117 and CD25 markers, and the patient's platelet-derived growth factor receptor alpha test was positive. Hence, the

Case Report: Uremia secondary to acute pyelonephritis in a patient with type 2 diabetes mellitus.

We report a 58-year-old male patient with acute kidney injury (AKI), who eventually developed anuria secondary to acute tubulointerstitial nephritis (ATIN) following acute pyelonephritis. Our patient had a 10-year history of type 2 diabetes mellitus, with an admission glycated hemoglobin (HbA1c) level of 6.3% and no prior history of renal disease. Before admission, he presented with painless gross hematuria and fever. Escherichia coli was detected in the urine culture at the local hospital, and anti-infective normalized his temperature, but urine output progressively decreased to anuria. After

Совпадение в полном тексте источника
… Coombs test results: direct antiglobulin test (DAT): polyspecific IgG+C3 (+), complement C3 (+), monospecific IgG (−). …

Clinical Oversight and Delayed Diagnosis of a Pathological Compression Fracture Causing Paraplegia.

While osteoporosis is the primary cause of vertebral compression fractures (VCFs), it's crucial to promptly recognize pathological fractures through comprehensive diagnostic tests, including vertebral biopsies, to determine the exact etiology. For instance, a 66-year-old male with osteoporosis experienced worsening lower limb weakness and back pain after an initial vertebroplasty for a T12 compression fracture. Subsequent MRI revealed severe circumferential extradural compression at T12, leading to further surgeries that eventually uncovered metastatic adenocarcinoma from a pancreatic tumor. T

Severe Pernicious Anemia: A Case Report.

Pernicious anemia is an infrequent condition and a recognized cause of vitamin B12 deficiency. It is an autoimmune disease that impairs the absorption of vitamin B12, leading to a significant reduction in its uptake. Clinical manifestations are often subtle and non-specific, yet potentially debilitating, which may delay diagnosis. However, with early recognition in primary care and appropriate replacement therapy, patients can recover their quality of life. Fatigue and asthenia are common complaints in primary care, highlighting the importance of careful clinical evaluation in the presence of

Совпадение в полном тексте источника
… A weakly positive direct Coombs test with negative subclasses suggested that a pure hemolytic process was unlikely. Anti-neutrophil cytoplasmic antibodies (ANCA) and antinuclear antibodies (ANA) were negative, excluding autoimmune conditions that may cause anemia of chronic disease. …

A case report on the treatment of autoimmune hemolytic anemia after CBT by daratumumab in a mucopolysaccharidosis type III patient.

RATIONALE: Mucopolysaccharidosis type III, also referred to as Sanfilippo disease, is a rare hereditary lysosomal storage illness and one of the more common variants. The illness can affect all tissues and organs of the body, with the central nervous system being the most profoundly impacted. Autoimmune hemolytic anemia (AIHA) is a rare, diverse, antibody-mediated disorder characterized by the production of antibodies that target and destroy red blood cells, leading to their rapid destruction. AIHA is a prevalent and notable complication in recipients following umbilical cord blood stem cell t

Isatuximab: A Review of Its Use in Multiple Myeloma.

Isatuximab (Sarclisa®; isatuximab-irfc in the USA) is an anti-CD38 monoclonal antibody (mAb) approved for use in the treatment of adults with multiple myeloma (MM): in combination with pomalidomide and dexamethasone for those with relapsed and refractory MM (RRMM) who have received ≥ 2 prior therapies, including lenalidomide and a proteasome inhibitor; and in combination with carfilzomib and dexamethasone for those with relapsed MM who have received ≥ 1 prior therapy. In phase III studies, the addition of isatuximab to pomalidomide and dexamethasone significantly prolonged progression-free sur

Совпадение в полном тексте источника
… By binding to CD38 expressed on the surface of red blood cells (RBCs), isatuximab may result in a false positive indirect antiglobulin test (indirect Coombs test) [ 16 , 17 ]; based on the half-life of the drug, this interference may persist for ≈ 6 months after the last infusion [ 16 ]. … The indirect Coombs test was positive in 68% and 63% of the tested isatuximab-treated patients in the phase III studies in patients with RRMM (ICARIA-MM) or relapsed or refractory MM (IKEMA) (Sect. 4 ) [ 17 , 28 , 29 ]. …

Аутоиммунные заболевания эфиопского и неэфиопского типа 1 Пациенты диабета в Израиле.

Распространение аутоиммунных заболеваний (АИД) у эфиопских пациентов различного типа 1 диабет (T1D) в основном неизвестен. Цель этого исследования состояла в том, чтобы выявить случаи совместного применения АИД у эфиопских пациентов Т1D и сравнить их распространенность с неэфиопскими израильскими пациентами. Ретроспективный когортный анализ 12,759 Т1D пациентов, в том числе 672 (В тыс.5.3%) лиц эфиопского происхождения, ≥ 18 Годы, зарегистрированные в базе данных медицинского обслуживания Клалита. Случаи насилия в отношении женщин были выявлены ICD-10 коды от 2000 в адрес 2023. Кроме того, был

Iron deprivation in cancer--potential therapeutic implications.

Iron is essential for normal cellular function. It participates in a wide variety of cellular processes, including cellular respiration, DNA synthesis, and macromolecule biosynthesis. Iron is required for cell growth and proliferation, and changes in intracellular iron availability can have significant effects on cell cycle regulation, cellular metabolism, and cell division. Perhaps not surprisingly then, neoplastic cells have been found to have higher iron requirements than normal, non-malignant cells. Iron depletion through chelation has been explored as a possible therapeutic intervention i

Chemotherapy-Associated Thrombotic Microangiopathy.

Thrombotic microangiopathy (TMA) is a syndrome of microangiopathic hemolytic anemia and thrombocytopenia with end-organ dysfunction. Although the advent of plasma exchange, immunosuppression, and complement inhibition has improved morbidity and mortality for primary TMAs, the management of secondary TMAs, particularly drug-induced TMA, remains less clear. TMA related to cancer drugs disrupts the antineoplastic treatment course, increasing the risk of cancer progression. Chemotherapeutic agents such as mitomycin-C, gemcitabine, and platinum-based drugs as well as targeted therapies such as anti

Совпадение в полном тексте источника
… The Coombs test is negative, consistent with intravascular hemolysis. …

The diagnostic journey of a young adult with recurrent infections and progressive dyspnoea.

Recurrent infections and unexplained bronchiectasis in adults should prompt evaluation for primary immunodeficiency. Early recognition and immunoglobulin therapy can improve outcomes in common variable immunodeficiency. https://bit.ly/4qy2qoJ.

Совпадение в полном тексте источника
… Detailed autoimmune work-ups including anti-cyclic citrullinated peptide antibodies, extractable nuclear antigen, antineutrophil cytoplasmic antibodies, rheumatoid factor, antinuclear antibody, Coombs test, thyroid peroxidase antibodies, anti-parietal cell antibody, gliadin deamidated antibody panel …

Integrating digital and narrative medicine in modern healthcare: a systematic review.

The increasing integration of digital technologies in healthcare, such as electronic health records, telemedicine, and diagnostic algorithms, improved efficiency but raised concerns about the depersonalization of care. Narrative medicine has emerged as a pedagogical and clinical response to this shift, emphasizing the value of patient stories, socio-cultural contexts, and reflective practice. Understanding how digital tools support, rather than undermine, narrative competencies is critical for developing a more human-centered healthcare education. This review systematically examined empirical

Multimodal imaging of bone metastases: From preclinical to clinical applications.

Metastases to the skeletal system are commonly observed in cancer patients, highly affecting the patients' quality of life. Imaging plays a major role in detection, follow-up, and molecular characterisation of metastatic disease. Thus, imaging techniques have been optimised and combined in a multimodal and multiparametric manner for assessment of complementary aspects in osseous metastases. This review summarises both application of the most relevant imaging techniques for bone metastasis in preclinical models and the clinical setting.

Endothelial Function in Patients with Hematologic Malignancies Undergoing High-Dose Chemotherapy Followed by Hematopoietic Stem Cell Transplantation.

The aim of the study was to examine endothelial function in patients with hematological malignancies treated with high-dose chemotherapy followed by hematopoietic stem cell transplantation. The studies were conducted on 43 consecutive patients qualified for HSCT following high-dose chemotherapy based on the current standards. Then, due to exclusion criteria, a group of 38 patients were chosen for further investigations. Evaluation of endothelial function by means of flow-mediated dilatation (FMD) was conducted in patients with hematological malignancies before HSCT (test A) and after HSCT (tes

Моноклональная гаммопатия как потенциальная причина чистой красной клетки Aplasia: Case Report and Literic Review.

Ранее сообщалось, что чисто красные клетки аплазии (ПРКА) являются вторичными по сравнению с плазменными клеточными дискразиями; однако эти случаи редки и зачастую не имеют клинических деталей. Здесь мы сообщаем о случае 44-year-old Женщина-пациентка с прогрессивной нормоцитической анемией при установлении монокланской гаммопатии IgG-kappa без соблюдения диагностических критериев для множественной миеломы или любой другой гематологической злокачественности. Несмотря на то, что первоначальная диагностика ПОПР была безрезультатной, и несмотря на переходную реакцию на эритропоизизизуализирующие в

Совпадение в полном тексте источника
… Although the direct antiglobulin test (Coombs test) was positive, there was no biochemical evidence of hemolysis. Serum protein electrophoresis revealed an M-protein spike of 13.7 g/L (IgG-kappa isotype) and an altered serum free light-chain (kappa/lambda) ratio of 5.4. …

Carfilzomib-Induced Thrombotic Microangiopathy: Focus on Pathogenesis.

Drug-induced thrombotic microangiopathies present in similar fashion but have varied pathogenic mechanisms. Carfilzomib is an irreversible proteasome inhibitor. Since its initial approval as a single agent for the treatment of relapsed or refractory multiple myeloma in 2012, there have been increasing reports of carfilzomib-induced thrombotic microangiopathy. However, the mechanism of this disease process is not fully understood. Without treatment, there is a high likelihood of end-organ damage, especially in the kidneys, and death. In recent reports, the lifesaving role of eculizumab, a termi

Совпадение в полном тексте источника
… In this report, our diagnosis of TMA was based on the laboratory findings of anemia, thrombocytopenia, schistocytes on the peripheral blood smear, elevated LDH, negative direct and indirect Coombs tests, hypertension, and proteinuria. …