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hemolytic anemia treatment

Fábio Bucaretchi, Maíra M Branco Pimenta, Carla F Borrasca-Fernandes, Camila Carbone Prado, Eduardo Mello De Capitani, Stephen Hyslop
CONTEXT: Thrombotic microangiopathy (TMA) is an uncommon and severe complication of snakebites, and is similar, in general, to hemolytic-uremic syndrome (HUS). We describe a case of TMA following envenomation by Bothrops jararaca. CASE DETAILS: A 56-y-old-woman with controlled hypertension was transferred from a primary hospital to our ER ∼7 h after being bitten by B. jararaca in the distal left leg. She developed edema extending from the bite site to the proximal thigh, associated with intense radiating local pain, local paresthesia and ecchymosis at the bite site...
November 16, 2018: Clinical Toxicology
Mohammadreza Salehi, Hosein Masoumi-Asl, Mehrdad Assarian, Niloofar Khoshnam Rad, Afsaneh Motevalli Haghi, Mehran Nikbakht, Hossein Khalili
BACKGROUND: In recent years, few cases of post-artemisinin delayed hemolysis have been reported. OBJECTIVE: All cases of post-artemisinin delayed hemolysis were reported from non-middle east areas. No case of post-artemisinin delayed hemolysis has yet been reported from this region. In this paper, we describe a case of post-artemisinin delayed hemolysis in an Iranian female. Also previous reports have been reviewed. METHOD: Patient's data including demographic characteristics, past medical, drug and travelling history, present illness, vital signs, laboratory data, clinical course of current illness and follow-up findings were considered...
November 9, 2018: Current Drug Safety
Christine W Bruggeman, Gillian Dekkers, Remco Visser, Naneth W M Goes, Timo K van den Berg, Theo Rispens, Gestur Vidarsson, Taco W Kuijpers
Intravenous immunoglobulins (IVIg) are used in the treatment of different autoimmune and inflammatory diseases, such as immune thrombocytopenia and hemolytic anemia. One of the modes of action of IVIg is preventing phagocytosis of autoantibody-opsonized blood cells by saturation of the Fc-gamma receptors of macrophages in spleen and liver. IgG contains a fixed glycan, which is in most cases biantennary, at the asparagine residue at position 297 in the Fc tail. This glycan consists of a core structure of N-acetyl glucosamine (GlcNAc) and mannose groups, variably extended with core fucose, bisecting GlcNAc as well as terminal galactose and sialic acid...
2018: Frontiers in Immunology
Sarvinder Singh, Santosh Kumar Singh, Ajai Kumar Tentu, Anshu Kumar, Bhaskar Shahbabu, Vani Singh, Nidhi Singh
Autoimmune hemolytic anemia (AIHA) is a very rare cause of anemia in a case of malaria and drug-induced AIHA is even rarer. A 50-year old patient with a history of fever for 8 days was diagnosed with a case of complicated malaria with mixed infection having initial parasite index of 45%. He showed good response on initial therapy with artesunate (parasite count reduced to <1%) but his haemoglobin (Hb) continued to drop from 12 g% to 4.9 g% over a course of 11 days. Direct coombs test was positive with reduced haptoglobin and increased lactate dehydrogenase suggesting AIHA...
October 2018: Indian Journal of Critical Care Medicine
Miguel G Uriol Rivera, Sheila Cabello Pelegrin, Carmen Ballester Ruiz, Bernardo López Andrade, Javier Lumbreras, Aina Obrador Mulet, Albert Perez Montaña, Mireia Ferreruela Serlavos, José Ignacio Ayestarán Rota, Joana Ferrer Balaguer, Olga Delgado Sanchez, Lucio Pallares Ferreres, Antonio Mas Bonet, María Jose Picado Valles, Rosa María Ruíz de Gopegui Valero
BACKGROUND: Thrombotic microangiopathy (TMA) is an important complication associated with several diseases that are rare and life-threatening. TMA is common to thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). TTP is defined by a severe deficiency of ADAMTS13, and early treatment is associated with good prognosis. The diagnosis of HUS can be difficult due to the potential multiple etiologies, and the best treatment option in most cases is not well-established yet...
2018: PloS One
Lei Yan, Xiao-Yan He, Xiang-Ping Xu, Sheng Huang, Dong-Lan Yan, Xue-Mei Qin, Jun-Sheng Tian
Hemolytic anemia is a common clinical disease with diverse pathogenesis. In recent years, the incidence of hemolytic anemia is increasing dramatically. The present clinical treatment of immunosuppressive agents or splenectomy is effective to some extent; however, the accompanied clinical adverse reactions are also significant. Traditional Chinese medicine (TCM) has beneficial therapeutic effect on hemolytic anemia, with the obvious advantages including curative effect, less adverse reactions, and low price...
September 2018: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Muhammad Shabbir Rawala, S Tahira Shah Naqvi, Muhammad Yasir Khan, Amr El Toukhy
BACKGROUND Thrombotic thrombocytopenic purpura is mostly characterized by symptoms and signs of hemolytic anemia, thrombocytopenia, renal impairment, fever and neurologic dysfunction. It is not always necessary to have all 5 characteristic symptoms, and presentations can vary. It can be congenital or acquired by any etiology that causes deficiency or dysfunction of ADAMST13 enzyme. CASE REPORT We present a case of a 71-year-old man who presented to our hospital initially with abdominal pain. He was diagnosed with pancreatitis, and conservative management was started with pain control and hydration...
October 30, 2018: American Journal of Case Reports
H Hanaoka, H Iida, T Kiyokawa, Y Takakuwa, K Kawahata
We determined the clinical utility of the direct Coombs' test in the absence of hemolytic anemia as an indicator of disease activity and therapeutic response in systemic lupus erythematosus (SLE). SLE patients without hemolytic anemia who visited our hospital from January 2016 to November 2016 were retrospectively evaluated with a direct Coombs' test. Clinical features, including SLE disease activity index (SLEDAI), treatment and laboratory findings were analyzed. For patients with lupus nephritis, we additionally evaluated the cumulative complete renal response rate over one year after induction therapy...
October 25, 2018: Lupus
José Carlos Jaime-Pérez, Patrizia Elva Aguilar-Calderón, Lorena Salazar-Cavazos, David Gómez-Almaguer
Evans syndrome (ES) is a rare and chronic autoimmune disease characterized by autoimmune hemolytic anemia and immune thrombocytopenic purpura with a positive direct anti-human globulin test. It is classified as primary and secondary, with the frequency in patients with autoimmune hemolytic anemia being 37%-73%. It predominates in children, mainly due to primary immunodeficiencies or autoimmune lymphoproliferative syndrome. ES during pregnancy is associated with high fetal morbidity, including severe hemolysis and intracranial bleeding with neurological sequelae and death...
2018: Journal of Blood Medicine
Jaqueline Ghosn, Alex Vicino, Olivier Michielin, George Coukos, Thierry Kuntzer, Michel Obeid
BACKGROUND: The prevalence of connective tissue disease (CTD) induced by immune checkpoint inhibitors (CPIs) in the absence of pre-existing autoimmunity is unknown. CASE PRESENTATION: We report the case of a melanoma patient treated for 8 months with pembrolizumab who developed a subacute ataxic sensory neuronopathy (SNN), including a right trigeminal neuropathy. Salivary gland biopsy showed inflammatory changes suggestive of Sjögren's syndrome, while brain MRI revealed enhancement of the right trigeminal ganglia...
October 22, 2018: Journal for Immunotherapy of Cancer
Giselle Volney, Michael Tatusov, Andy C Yen, Nune Karamyan
Naphthalene poisoning is a rare form of toxicity that may occur after ingestion, inhalation, or dermal exposure to naphthalene-containing compounds such as mothballs. Clinically, patients present with acute onset of dark brown urine, watery diarrhea, and non-bloody bilious vomiting 48-96 hours after exposure. Vital sign abnormalities include fever, tachycardia, hypotension, and persistent pulse oximetry readings of 84%-85% despite oxygen supplementation. Laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anemia, methemoglobinemia, and renal dysfunction...
August 15, 2018: Curēus
Serife Solmaz Medeni, Sinem Namdaroglu, Tugba Cetintepe, Can Ozlu, Funda Tasli, Zehra Hilal Adibelli, Oktay Bilgir, Erhan Tatar
Atypical hemolytic uremic syndrome is a rare and progressive disease caused by uncontrolled alternative complement activation. Dysregulatıon of the complement activation results in thrombotic microangiopathy and multiorgan damage. A 29-yearold woman who was admitted with complaints of vomiting and headache was detected to have acute renal failure with microangiopathic hemolytic anemia (MAHA). After the diagnosis of atypical hemolytic uremic syndrome (aHUS), she was treated with plasma exchange (PE) and hemodialysis (HD)...
September 5, 2018: Hematology Reports
I Gheith, A El-Mahmoudy
This study was designed to provide laboratory evidence supporting the hematopoietic effect of Beta vulgaris (beet) leaf aqueous extract in phenylhydrazine-induced anemia model in albino rats. Extraction of the leaves/stalks was done by maceration in 30% hydro-ethanol for 48 h. An intraperitoneal injection of 20 mg/kg phenylhydrazine was applied for two consecutive days to develop hemolytic anemia on the 4th day after the 1st injection in 24 of 30 male albino rats. The animals were divided into 5 groups and received the following treatments: standard (ferrous ascorbate + folic acid; 13...
October 11, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Serena I Tripodi, Paola Corti, Silvia Giliani, Arnalda Lanfranchi, Andrea Biondi, Raffaele Badolato
We describe a previously healthy 14-year-old girl with acute onset autoimmune hemolytic anemia, associated with severe but transient lymphopenia during corticosteroid therapy, without infectious episodes during follow-up. After detailed investigations to rule out an underlying immunodeficiency, we detected a heterozygous ADA gene mutation. This was associated with slightly increased blood levels of adenosine and deoxyadenosine nucleotides and with reduced ADA activity in red blood cells, but within the normal range...
2018: Frontiers in Pediatrics
Meriem Ladli, Cyrielle Richard, Lilia Cantero Aguilar, Sarah Ducamp, Sabrina Bondu, Pierre Sujobert, Jérôme Tamburini, Catherine Lacombe, Nabih Azar, Marc Foretz, Yael Zermati, Patrick Mayeux, Benoit Viollet, Frédérique Verdier
AMP-activated protein kinase is a heterotrimeric complex containing α, β, and γ subunits involved in maintaining integrity and survival of murine red blood cells (RBC). Indeed, Ampk α1-/-, Ampk b1-/- and Ampk γ1-/- mice present a hemolytic anemia and their RBC show elasticity defects in their plasma membrane. The membrane composition evolves continuously along erythropoiesis and during RBC maturation; defects due to the absence of AMPK could be initiated during erythropoiesis. Therefore, we aim to study the role of AMPK during human erythropoiesis...
October 11, 2018: Haematologica
Takayuki Ikezoe
The clinical features of transplant-associated thrombotic microangiopathy (TA-TMA) include microangiopathic hemolytic anemia, consumptive thrombocytopenia, and organ dysfunction caused by thrombi in microvessels. The pathogenesis of TA-TMA is based on vascular endothelial insults caused by various factors, including chemotherapy and total-body irradiation used for transplant pre-conditioning, calcineurin inhibitors, cytokines release associated with infection, and complement factors. The incidence of TA-TMA is approximately 15-30% among allogeneic transplant patients, and the mortality rate reaches 100% in severe cases with multi-organ dysfunction...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Tristan Knight, Yaddanapudi Ravindranath, Michael U Callaghan
Evans syndrome is defined by bilineal autoimmune cytopenia, typically coombs positive hemolytic anemia and thrombocytopenia. Corticosteroids are the mainstay of treatment, with rituximab and/or mycophenolate mofetil often used in steroid-refractory cases. However, no treatment methodology has ever evaluated by a randomized clinical trial. We present a 15-year-old boy with Evans syndrome and common variable immunodeficiency who experienced a severe, refractory flare 16 months postsplenectomy. After failing to respond to multiple other agents, he achieved a durable response to a bortezomib-based regimen...
October 5, 2018: Journal of Pediatric Hematology/oncology
Rupesh Raina, Vinod Krishnappa, Taryn Blaha, Taylor Kann, William Hein, Linda Burke, Arvind Bagga
Atypical hemolytic uremic syndrome (aHUS), a rare variant of thrombotic microangiopathy, is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment. The condition is associated with poor clinical outcomes with high morbidity and mortality. Atypical HUS predominantly affects the kidneys but has the potential to cause multi-organ system dysfunction. This uncommon disorder is caused by a genetic abnormality in the complement alternative pathway resulting in over-activation of the complement system and formation of microvascular thrombi...
October 8, 2018: Therapeutic Apheresis and Dialysis
Jennifer Vanoli, Andrea Carrer, Roberto Martorana, Guido Grassi, Michele Bombelli
BACKGROUND: Vitamin B12 deficiency-induced thrombotic microangiopathy, known as pseudothrombotic microangiopathy, is a rare condition which resembles the clinical features of thrombotic thrombocytopenic purpura but requires a markedly different treatment. Most cases of vitamin B12 deficiency have only mild hematological findings, but in approximately 10% of patients life-threatening conditions have been reported. CASE PRESENTATION: We report a case of a 46-year-old Moroccan man presenting with severe hemolytic anemia, thrombocytopenia, and renal failure in absence of macrocytosis, thus mimicking a genuine thrombotic thrombocytopenic purpura...
October 3, 2018: Journal of Medical Case Reports
Michael A Brock, Mark S Bleiweis, Jana Reid, Diego Moguillanksy
We present the case of a 29-year-old male with a history of Mizuho hemolytic anemia, a rare form of unstable hemoglobinopathy, who presented with congestive heart failure secondary to recurrent valve thrombosis despite appropriate oral anticoagulation. He subsequently required mitral and aortic valve replacement. Pathologic examination revealed extensive nonbacterial thrombotic endocarditis. Due to recurrent thrombosis despite therapeutic anticoagulation, we elected to treat him with red blood cell exchange transfusions and hydroxyurea...
May 2018: Journal of Cardiology Cases
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