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Bone marrow necrosis and pulmonary fat embolism

Radhika Gangaraju, Vishnu V B Reddy, Marisa B Marques
Bone marrow necrosis with subsequent embolization of the fat and necrotic tissues into the systemic circulation causing fat embolism syndrome and multiorgan failure is a rare complication of patients with hemoglobinopathies. The exact etiology of this condition is not known. Because it occurs more often in patients with compound heterozygous conditions than in sickle cell disease, some patients are unaware of their predisposition. The initial symptoms are nonspecific, such as back and/or abdominal pain, fever, and fatigue, which may rapidly progress to respiratory failure and severe neurologic compromise...
September 2016: Southern Medical Journal
Laurane Cottin, Camille Rouvet, Chadi Homedan, Mathieu Conté, Satar Mortaza, Marie-Christine Rousselet, Anne Corby, Maïlys Le Guyader, Marc Zandecki, Pascal Reynier
We describe the case of a 30-year-old patient, suffering from composite S/β + sickle cell disease. He was hospitalized following a vaso-occlusive attack with acute bone pains. Despite an analgesic treatment and transfusion of three units of red blood cells, a non-regenerative anemia appeared within 24 hours. One day later an acute chest syndrome with atelectasis of the left lung and desaturation and multi-organ failure occurred and necessitated the patient's intubation and required him to be placed in an artificial coma...
September 2014: Annales de Biologie Clinique
Darwish Naji, Shehabaldin Alqalyoobi, Betty Herndon, Agostino Molteni, Gary Salzman
ARDS/Lung Injury PostersSESSION TYPE: Original Investigation PosterPRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PMPURPOSE: In humans fat embolism (FE: from marrow lipids reaching the lung secondary to long bone fracture) is seen early post injury as respiratory insufficiency which clears without intervention. It is commonly believed that there are no long term pulmonary sequelae after FE-although human studies have shown decreased PFTs in groups with healed long bone fractures compared to controls...
October 1, 2014: Chest
Joseph Christopher Schaffer, Farshad Adib, Quanjun Cui
Osteonecrosis (ON) of the femoral head, without timely intervention, often progresses to debilitating hip arthritis. Core decompression (CD) with bone grafting was used to treat patients with early-stage ON. In 3 cases, intraoperative oxygen saturation, end-tidal carbon dioxide fluctuations, and/or vital sign fluctuations were observed during insertion of the graft, a mixture of bone marrow and demineralized bone matrix. In 1 case, continued postoperative pulmonary symptoms required admission to intensive care...
June 2014: American Journal of Orthopedics
Melissa Rayburg, Karen A Kalinyak, Alexander J Towbin, Peter B Baker, Clinton H Joiner
No abstract text is available yet for this article.
March 2010: American Journal of Hematology
Michael K Urban, Kethy M Jules-Elysee, James B Beckman, Khillil Sivjee, Thomas King, Webster Kelsey, Oheneba Boachie-Adjei
BACKGROUND CONTEXT: Previous reports have shown that 15% of patients who undergo sequential anterior, then posterior, surgical corrections for spinal deformities demonstrate evidence of acute lung injury. By analyzing the bronchoalveolar lavage (BAL) fluid from these patients for evidence of acute inflammation, we might gain some insight into the etiology of this acute lung injury. PURPOSE: To elucidate the etiology of acute lung injury after corrective surgery for adult spinal deformities...
May 2005: Spine Journal: Official Journal of the North American Spine Society
Michael Oberst, Alexander Bosse, Ulrich Holz
This study shows the local changes in intramedullary pressure during a new endoscopic technique for the medullary canal of the long bone. The procedure of intramedullary bone endoscopy (IBE) was performed on 4 tibial amputations. By slowly pushing the endoscope distally under visual control and endoscopic preparation of the medullary canal, a "neocavum" for endoscopy was created. During the procedure, the intramedullary pressure was continuously measured: Highest peak pressure was 125 mm Hg. We therefore conclude that the procedure of IBE is a safe intervention within the medullary canal of the long bone...
May 2004: Arthroscopy: the Journal of Arthroscopic & related Surgery
Young-Hoo Kim, S-W Oh, J-S Kim
BACKGROUND: Controversy exists regarding the safety of bilateral simultaneous total hip arthroplasty, in part because of the potentially higher prevalence of pulmonary fat embolism. The purpose of the present study was to determine if unilateral and bilateral simultaneous total hip arthroplasty procedures resulted in different prevalences of fat embolization, different degrees of hemodynamic compromise, or different levels of hypoxemia or mental status changes. METHODS: One hundred and fifty-six consecutive patients undergoing primary total hip arthroplasty were prospectively enrolled in the study...
August 2002: Journal of Bone and Joint Surgery. American Volume
(no author information available yet)
No abstract text is available yet for this article.
October 30, 1997: New England Journal of Medicine
S Hofmann, G Huemer, C Kratochwill, J Koller-Strametz, R Hopf, G Schlag, M Salzer
It is well known that fat embolisms can occur after long bone fractures, and this has been feared for more than 100 years. Since 1970 fat embolisms have also been recognized in endoprosthetic surgery. The clinical manifestation was described as the fat embolism syndrome (FES) by Gurd in 1974. Based on reports in the literature and our own data, a concise pathophysiological model of the FES is presented in this paper. The increase in intramedullary pressure (IMP) in the long bones is the most decisive pathogenic factor for the development of an FES...
April 1995: Der Orthopäde
S Charache, D L Page
No abstract text is available yet for this article.
December 1967: Annals of Internal Medicine
J A Garza
A case of sickle cell disease diagnosed postmortem is described. A 37-year-old black woman presented with anemia, respiratory distress, and abdominal and back pain. Death followed an intramuscular injection of iron, and anaphylaxis was clinically diagnosed. At autopsy, massive fat and necrotic bone marrow embolization of pulmonary and renal vessels was found. In the vertebral column, multifocal areas of ischemic necrosis were present, and proved to be the source of this embolization. Sickled red cells appeared in bone marrow sinusoids, and signs of disseminated intravascular coagulation were present...
March 1990: American Journal of Forensic Medicine and Pathology
E Tsou, S Katz
When a patient with sickle cell disease has fever and a lung infiltrate, usually it will be due to infection, even though cultures may be negative. However, pulmonary infarction can be virtually indistinguishable from pneumonia. Pneumonia is likely to be present in those younger than five years, with purulent sputum and upper lobe infiltrates. Coexisting crisis, a normal or low leukocyte alkaline phosphatase score and microangiopathic changes on peripheral blood smear favor thromboembolic disease. The fat embolism syndrome, caused by bone marrow necrosis and infarction, occurs in sickle cell disease...
October 1977: American Family Physician
G J Wang, D B Moga, W G Richemer, D E Sweet, S I Reger, R C Thompson
Thirty-two rabbits were used experimentally to study the effect of cortisone in bone, lungs, kidneys, and liver. Cortisone does induce abnormal increases in the serum cholesterol, fatty metamorphosis of the liver and the fatty emboli of the subchondral vessels of the femoral heads. Clofibrate therapy appeared to modify the cortisone induced changes as evidenced by a lower serum cholesterol level, prevention or lessening of the increase in the marrow fat cell size. This might significantly improve microcirculation of the femoral head...
January 1978: Clinical Orthopaedics and related Research
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