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Case Reports in Hematology

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https://read.qxmd.com/read/30766737/atypical-thrombotic-thrombocytopenic-purpura-presenting-as-stroke
#1
Pradeepthi Badugu, Modupe Idowu
Here we report a case of atypical thrombotic thrombocytopenic purpura that presented as an ischemic cerebrovascular accident. A 56-year-old man with multiple cardiovascular risk factors presented with sudden left-sided weakness, slurred speech, and left facial droop. He showed mild improvement when he was treated with thrombolytic therapy according to the hospital stroke protocol. Later in the course, he developed thrombocytopenia followed by schistocytes revealed by peripheral blood smear and other lab abnormalities...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30729051/autoimmune-associated-hemophagocytosis-and-myelofibrosis-in-a-newly-diagnosed-lupus-patient-case-report-and-literature-review
#2
Deonne Thaddeus V Gauiran, Paula Victoria Catherine Y Cheng, Christopher Ryan P Pagaduan, Maria Clariza M Santos
Bone marrow abnormalities in SLE are now becoming increasingly recognized, suggesting that the bone marrow may also be an important site of target organ damage. In this study, we present a rare case of concurrent autoimmune hemophagocytic syndrome and autoimmune myelofibrosis, potentially life-threatening conditions, in a newly diagnosed SLE patient. We report a case of a 30-year-old Filipino woman who presented with a one-year history of fever, constitutional symptoms, exertional dyspnea, joint pains, and alopecia and physical examination findings of fever, facial flushing, cervical lymphadenopathies, and knee joint effusions...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30729050/chronic-lymphocytic-leukemia-presenting-as-a-subcortical-watershed-infarct
#3
Mridul Gupta, Divita Singh, Patrick Lee, Sandhya Kadiyam
Internal watershed infarcts (WI) involve white matter between deep and superficial arterial systems of middle cerebral artery. These infarcts are considered to be either from low blood flow or microembolism. Anemia is an extremely rare cause of watershed infarcts. Very few cases of hemolytic anemia causing watershed cerebral infarcts have been reported. Chronic lymphocytic leukemia (CLL) is frequently complicated with secondary autoimmune cytopenia such as autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), and pure red cell aplasia...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30729049/false-negative-platelet-factor-4-antibodies-and-serotonin-release-assay-and-the-utility-of-repeat-testing-in-the-diagnosis-of-heparin-induced-thrombocytopenia-and-thrombosis
#4
Tarig Omer, Naresh Mullaguri, Pravin George, Christopher R Newey
Objective: To report a case of false-negative serological tests in the diagnosis of heparin-induced thrombocytopenia (HIT) followed by a brief review of the literature on this topic. Case Presentation: A 75-year-old Caucasian female patient was admitted with a traumatic right ankle fracture that required open reduction and internal fixation. Despite postoperative subcutaneous heparin chemoprophylaxis, she developed deep vein thrombosis (DVT) and pulmonary embolism (PE) on day 4 and subsequently started on continuous heparin infusion...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30723558/the-implications-of-liver-biopsy-results-in-patients-with-myeloproliferative-neoplasms-being-treated-with-ruxolitinib
#5
Douglas Tremblay, Juan Putra, Alexander Vogel, Adam Winters, Ronald Hoffman, Thomas D Schiano, Maria Isabel Fiel, John O Mascarenhas
Ruxolitinib is increasingly being utilized for the treatment of myelofibrosis and polycythemia vera, but the potential for hepatic toxicity is poorly understood. We performed a retrospective review of hepatic damage occurring in patients with myeloproliferative neoplasms receiving ruxolitinib. Relevant histologic images of liver biopsies were reviewed by an experienced liver pathologist and reported to a multidisciplinary team including hepatology and hematology. A variety of liver pathology was observed including extramedullary hematopoiesis, obliterative portal venopathy, and drug-induced liver injury...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30719361/durable-leukemic-remission-and-autologous-marrow-recovery-with-random-chromosomal-abnormalities-after-allogeneic-hematopoietic-stem-cell-transplantation-for-chronic-lymphocytic-leukemia
#6
Hidekazu Nishikii, Naoki Kurita, Atsushi Shinagawa, Tatsuhiro Sakamoto, Manabu Kusakabe, Yasuhisa Yokoyama, Takayasu Kato, Mamiko Sakata-Yanagimoto, Naoshi Obara, Yuichi Hasegawa, Naoya Nakamura, Shigeru Chiba
A 38-year-old woman with aggressive clinical course of chronic lymphocytic leukemia (CLL) was treated with 8 courses of R-CHOP. Clinical remission was achieved, while B-cell clonality remained. Allogeneic hematopoietic stem cell transplantation was performed with reduced intensity conditioning (fludarabine and 2-Gy total body irradiation). However, autologous hematopoietic recovery occurred within a month after the transplant. Nevertheless, B-cell clonality became undetectable at 14 days after transplant, which has been kept so for over 10 years with clinical remission...
2019: Case Reports in Hematology
https://read.qxmd.com/read/30671268/thrombotic-thrombocytopenic-purpura-due-to-checkpoint-inhibitors
#7
Alexey Youssef, Nawara Kasso, Antonio Sergio Torloni, Michael Stanek, Tomislav Dragovich, Mark Gimbel, Fade Mahmoud
Ipilimumab is a monoclonal antibody that enhances the efficacy of the immune system by targeting a cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), which is a protein receptor that downregulates the immune system. Nivolumab is also a humanized monoclonal antibody that targets another protein receptor that prevents activated T cells from attacking the cancer; this receptor is called programmed cell death 1 (PD-1). The FDA approved ipilimumab combined with nivolumab as a frontline therapy for patients with metastatic melanoma or renal cell carcinoma and as a second-line therapy for patients with microsatellite instability-high (MSI-H) metastatic colon cancer...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30662779/the-use-of-natural-health-products-especially-papaya-leaf-extract-and-dandelion-root-extract-in-previously-untreated-chronic-myelomonocytic-leukemia
#8
Leena T Rahmat, Lloyd E Damon
Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic disorder which shares clinical and morphological features of myelodysplastic syndrome and myeloproliferative neoplasms. Conventional therapeutic options include hydroxyurea, hypomethylating agents, and systemic chemotherapy, which are all palliative measures and are associated with potential side effects. Allogeneic hematopoietic cell transplantation is the only curative option. Natural health products such as papaya leaf extract and dandelion root extract have been shown to demonstrate anticancer activity in preclinical and clinical studies, respectively...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30662778/an-unusual-coexistence-of-primary-central-nervous-system-non-hodgkin-s-lymphoma-and-acute-promyelocytic-leukemia
#9
Nicola Stefano Fracchiolla, Mariarita Sciumè, Giulia Cernuschi, Agostino Cortelezzi
Acute promyelocytic leukemia and primary central nervous system lymphoma are uncommon hematological malignancies. The co-occurrence of acute myeloid leukemia with various lymphoproliferative diseases is an extremely rare condition, especially in the absence of previous chemotherapy or radiotherapy. Herein, we provide a comprehensive characterization of a patient with concomitant diagnosis of extranodal high-grade non-Hodgkin B-cell neoplasm confined to the central nervous system and acute promyelocytic leukemia...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30647983/cyclin-dependent-kinase-4-6-inhibitor-palbociclib-induced-aplastic-anemia-in-a-patient-with-metastatic-breast-cancer
#10
Stanley Madu Nwabudike, Camille V Edwards, Oladimeji Akinboro, Kathryn Quinn, Shayna Sarosiek, Naomi Ko
Breast cancer is the most common cancer diagnosed in women worldwide. Over the years, breast cancer treatment has undergone revolutionary changes especially for women with hormone receptor positive metastatic disease. As a result, women are living longer with their disease, particularly in developed countries. The use of cyclin-dependent kinase (CDK) 4/6 inhibitors with antiestrogen therapy is a relatively new therapeutic option which has been shown to improve progression-free survival. Hematologic adverse events, most frequently neutropenia, are well-known side effects of CDK 4/6 inhibitors...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30647982/a-rare-case-of-triple-negative-essential-thrombocythemia-in-a-young-postsplenectomy-patient-a-diagnostic-challenge
#11
T Akcan, P Strati, M Yan, M Idowu
The distinction between primary and reactive thrombocytosis by bone marrow histology is very important. Reactive thrombocytosis, the most common cause of thrombocytosis, can be expected in postsplenectomy states; however, close hematological evaluation of prolonged thrombocytosis is essential to identify patients who may have an underlying myeloproliferative neoplasm. We report a 37-year-old woman who was found to have portal, mesenteric, and splenic vein thrombosis with thrombocytosis, two months after she had a splenectomy for spontaneous splenic rupture...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30647981/dysphagia-as-an-unusual-presentation-of-myeloma
#12
A Raissi, Z Chahbi, M Zyani, Y Darouassi
Multiple myeloma is a plasma cell dyscrasis characterized by mature B cells proliferation in the bone marrow. In rare cases, the disease can present as an extramedullary location, making diagnosis and management more challenging. Here, we describe a rare case of tongue extramedullary myeloma and discuss diagnostic, prognostic, and therapeutic issues.
2018: Case Reports in Hematology
https://read.qxmd.com/read/30647980/a-case-of-myeloproliferative-neoplasm-with-bcr-fgfr1-rearrangement-favorable-outcome-after-haploidentical-allogeneic-transplantation
#13
Paola Villafuerte-Gutiérrez, Montserrat López Rubio, Pilar Herrera, Eva Arranz
Hematopoietic myeloproliferative neoplasms with FGFR1 rearrangement result in the 8p11 myeloproliferative syndrome that in the current Word Health Organization classification is designated as "myeloid and lymphoid neoplasm with FGFR1 abnormalities." We report the case of a 66-year-old man who had clinical features that resembled chronic myeloid leukaemia (CML), but bone marrow cytogenetic and fluorescent in situ hybridization (FISH) studies showed t(8;22)(p11;q11) and BCR-FGFR1 fusion gene. He was initially managed with hydroxyurea, and given the aggressive nature of this disease, four months later, the patient underwent an allogeneic hematopoietic stem-cell transplantation (HSCT) from an HLA-haploidentical relative...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30627461/obstructive-jaundice-due-to-pancreatic-involvement-as-an-initial-presentation-of-adult-acute-lymphoblastic-leukemia
#14
Oreoluwa Oladiran, Ifeanyi Nwosu
Acute lymphoblastic leukemia (ALL) is a heterogeneous group of lymphoid disorders characterized by monoclonal proliferation and expansion of immature lymphoid cells in the bone marrow, blood, and other organs. It commonly presents with nonspecific symptoms such as lethargy, easy bruising, and weight loss. In this article, we present the case of a 48-year-old male who presented to the hospital with painless jaundice resulting from pancreatic infiltration, initially thought to be due to pancreatic or hepatobiliary malignancy...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30627460/blastoid-variant-mantle-cell-lymphoma-expressing-aberrant-cd3-and-cd10-with-concurrent-small-lymphocytic-lymphoma-establishment-of-a-clonal-relationship-by-b-and-t-cell-receptor-gene-rearrangements
#15
Christopher L Felten, Joel A Chan, Dulce R DeCastro, Jean Lopategui, Swapnil P Rajurkar
Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin B-cell lymphoma typically expressing CD19, CD20, CD5, FMC-7, CyclinD1, and SOX-11 and harboring the IgH/CCND1 translocation. We report a blastoid variant of mantle cell lymphoma (MCL) involving an inguinal lymph node that, in addition to classical phenotypic and genetic findings, also aberrantly coexpresses surface CD10 and cytoplasmic CD3. Small lymphocytic lymphoma (SLL) was also present in the same lymph node and in the bone marrow. B- and T-cell gene rearrangement studies by PCR show the MCL and SLL to be clonally related...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30627459/efficacy-of-carfilzomib-lenalidomide-and-dexamethasone-for-extramedullary-intracranial-localization-of-multiple-myeloma
#16
Giuseppe Mele, Domenico Pastore
EMD of myeloma usually occurs several years after diagnosis and is associated with a very poor OS of <6 months due to the fact that there are no efficient treatment options. In rrMM with EMDs, the most effective treatment is a lymphoma-like polychemotherapy regimen such as PACE, Dexa-BEAM, and HyperCVAD followed by ASCT or allogeneic SCT. RT of soft-tissue plasmacytoma is the further treatment choice and results in a high rate of local control and a prolonged disease-free survival. We report the case of a 41-year-old man affected by ultra-high-risk symptomatic IgA λ MM with extramedullary intracranial soft-tissue relapsed after VTD-PACE followed by ASCT...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30595928/philadelphia-translocation-in-mds-a-case-report-and-a-brief-review-of-the-literature-looking-at-its-prevalence-disease-progression-and-treatment-options
#17
Lakshmi Ramya Chelapareddy, Sandeep Sen
Myelodysplastic syndrome (MDS) is a group of clonal disorders characterized by ineffective and dysplastic hematopoiesis in the bone marrow with variable risk of progression to leukemia. MDS is characterized by specific karyotypic and molecular abnormalities. The t(9 : 22) Philadelphia translocation is not a common abnormality found in MDS, and it is not included in the prognostic indices for germline mutations. There are no definitive treatment guidelines for these patients either. Here, we reviewed previously reported cases of MDS with the Philadelphia translocation with a goal to determine their prognosis and treatment options, specifically the tyrosine kinase inhibitors (TKIs)...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30538872/paroxysmal-cold-hemoglobinuria-in-an-adult-with-respiratory-syncytial-virus
#18
Ryan Leibrandt, Kenneth Angelino, Monique Vizel-Schwartz, Ilan Shapira
Paroxysmal cold hemoglobinuria (PCH) is a rare form of cold autoimmune hemolytic anemia first discovered in the early 20th century in adults with tertiary syphilis. Today, it is more commonly seen in children as a life-threatening anemia during a viral upper respiratory tract infection (URI). Although respiratory syncytial virus (RSV) has previously been reported to cause PCH in a child, herein we present the first documented case in an adult. The Donath-Landsteiner (DL) test, the diagnostic test for PCH, was positive on two separate occasions...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30538871/management-of-acquired-hemophilia-a-in-elderly-patients
#19
Tomoya Yamaguchi, Naoko Kudo, Susumu Endo, Takeo Usui, Shinsaku Imashuku
This report describes six elderly patients with acquired hemophilia A (AHA), including four individuals aged ≥90 years. Bleeding symptoms were subcutaneous or intramuscular hemorrhage ( n =4), hematuria ( n =1), and hemorrhagic shock after tooth extraction ( n =1). Factor VIII (FVIII) activity ranged from <1.0% to 3.0%, and anti-FVIII inhibitor titers ranged from 8.8 to 240 BU/mL. Treatment was administered at the discretion of the responsible physician. Hemostatic agents applied in the six patients comprised rFVIIa (NovoSeven®) ( n =4), APCC (Feiba®) ( n =2), and fresh frozen plasma/plasma exchange ( n =1)...
2018: Case Reports in Hematology
https://read.qxmd.com/read/30534450/transitory-spontaneous-remission-of-myelodysplasia-in-an-elderly-man-while-receiving-intravesical-bacillus-calmette-gu%C3%A3-rin-for-bladder-cancer-a-case-report-and-review-of-the-literature
#20
Nigel P Murray, Cynthia Fuentealba, Isidora Salazar, Aníbal Salazar, Marco Antonio Lopez, Simona Minzer
Myelodysplasia is a clonal disorder characterized by progressive cytopenias. Intravescial BCG is standard immunotherapy for superficial bladder cancer. We present a patient with transfusion-dependent myelodysplasia whose blood counts normalized during treatment with intravesical BCG for bladder cancer. After finishing treatment, the patient became transfusion dependent once more. We discuss possible mechanisms to explain this case report.
2018: Case Reports in Hematology
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