1,721,355 research outputs found
Multiple actinic keratoses and lichenoid eruption induced by hydroxyurea and sun exposure
No full textA case of a 70-year-old man with multiple actinic keratoses and lichenoid lesions on sun-exposed skin areas, is reported. The patient, splenectomised for an idiopathic myelofibrosis, was treated with hydroxyurea. Phototesting, with daily doses of UVA 5 J/cm2 and UVB 60 mJ/cm2 on a fixed skin area for 8 consecutive days, elicited a lichenoid eruption. The interruption of the hydroxyurea treatment together with a careful photoprotection gave rise to an improvement of lichenoid lesions
Spleen sizing by ultrasound scan and risk of pneumococcal infection in patients with chronic GVHD: preliminary observations.
No full textEncapsulated bacteria infections (EBI) can cause severe complications after BMT, usually occurring in patients with chronic GVHD (cGVHD) and attributed to functional hyposplenism. Using ultrasound (US) scan, we measured spleen size in 22 patients transplanted from HLA identical siblings, with or without cGVHD. No patient had received TBI, spleen irradiation or penicillin prophylaxis. Results were correlated with occurrence of EBI during a mean follow-up of 55 months (range 7-93). In the group without cGVHD, the difference between pre- and post-BMT spleen longitudinal diameters was not significant, and no patient developed EBI. In the cGVHD group, post-BMT spleen longitudinal diameters were significantly smaller than those pre-BMT (9.1 ± 1.6 vs 12.3 ± 2.2; P = 0.0005). Out of four patients with cGVHD who showed a major spleen size reduction, two developed a severe infection (an overwhelming sepsis and a pneumococcal meningitis). In our small series, we found a borderline relationship between spleen size reduction and duration of cGVHD (P = 0.06), as well as an increased risk of life-threatening infection in patients with extensive cGVHD and hyposplenism as detected by US scan. We conclude that US scan may be useful to detect spleen size reduction following allogeneic BMT and that penicillin prophylaxis is to be strongly recommended in patients with extensive cGVHD and spleen size reduction, even in those who have not received total body or spleen irradiation
Decreased number of circulating BFU-Es in Paroxysmal Nocturnal Hemoglobinuria
No full textIn order to quantitate early erythroid progenitor cells in paroxysmal nocturnal hemoglobinuria (PNH), we have cultured peripheral blood mononuclear cells from 7 PNH patients in a 0.8% methylcellulose medium containing erythropoietin, 2 U/ml. In our experimental conditions, the number of erythroid colonies obtained per 5 X 10(5) mononuclear cells plated was 20.1 +/- 1.9 (SEM) in normal subjects and 2.8 +/- 0.56 (SEM) in PNH patients. In plates from PNH subjects, 38 of 117 showed no growth of erythroid colonies, whereas plates from normal subjects always had colonies. Our findings suggest that PNH patients, despite their hemolytic condition, have a depleted erythroid precursor compartment, and this may play a major role in the pathogenesis of their anemia
Ultrasound exploration in the work-up of unexplained fever in the immunocompromized host: preliminary observations.
No full textIn immunocompromized hosts, febrile episodes
have an unknown origin (FUO) in about fifty per
cent of cases. In this preliminary study we evaluated
the role of abdominal and pleural ultrasound
(US) examination for early detection of infectious
sites. US exploration was performed in a cohort of
14 consecutive FUO patients early after fever
onset, at patients’ bedside, by a hematologist
trained in diagnostic ultrasound, and it was
repeated at neutrophil recovery. US exploration
showed abnormal abdominal findings in 7 and
pleural effusion in 3 patients. In all cases but one
the abnormality was found at the first US examination.
Abdominal and pleural US exploration is a
low-cost, easy to use tool for the work-up of FUO
in the immunocompromized host that proved to
be effective in identifying the infection site in about
50% of patients
- …
