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https://www.readbyqxmd.com/read/29101508/a-sticky-situation-myocardial-infarction-in-a-young-woman-with-immune-thrombocytopenia-on-eltrombopag-and-a-history-of-mediastinal-radiation
#1
Jennifer Teichman, Ahmed Taher, Abdulaziz Hashi, Akshay Bagai, Michelle Sholzberg
More recent immune thrombocytopenia (ITP) treatment strategies enhance platelet production with the use of thrombopoietin receptor agonists (TPO-RA) such as eltrombopag. Patients receiving TPO-RA agents may be at an increased risk of thromboembolism, however the pathophysiology and common underlying risk factors are not well understood. We present the case of a young asplenic woman on eltrombopag for chronic ITP with acute myocardial infarction involving the right coronary artery. Past medical history was significant for remote mediastinal radiation for lymphoma and splenectomy for ITP...
November 3, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29046517/a-rare-association-of-congenital-asplenia-with-jejunal-arteriovenous-malformation
#2
Jelena Z Arnautovic, Areej Mazhar, Stela Tereziu, Kashvi Gupta
BACKGROUND Isolated congenital asplenia is a poorly understood and rare form of primary immunodeficiency, often associated with life-threatening infections. CASE REPORT We encountered a unique case of a 22-year-old asplenic male who presented with severe iron-deficiency anemia secondary to occult gastrointestinal bleeding since age 15. Our extensive work-up confirmed jejunal arteriovenous malformations as the source of the bleed. Six months after the treatment, the patient has reported no further episodes of gastrointestinal bleeding and his hemoglobin has remained stable...
October 19, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28870849/perioperative-management-of-asplenic-patients-in-france-a-national-survey-among-anaesthetists-intensivists
#3
Ludivine Rousseau, Thomas Kerforne, Matthieu Boisson, Olivier Mimoz, Claire Dahyot-Fizelier
No abstract text is available yet for this article.
September 1, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28858039/fulminant-haemophilus-influenzae-type-a-infection-in-a-4-year-old-with-previously-undiagnosed-asplenic-heterotaxy
#4
Andrew Headrick, Erinn O Schmit, David W Kimberlin
The post Hib-vaccine era has resulted in increased cases of invasive, non-Hib, Haemophilus influenzae infections. One of the encapsulated species, type a, displays the most similarity in virulence to type b. Our patient, a fully-vaccinated four-year-old female, with newly diagnosed asplenia in the setting of heterotaxy, had a prolonged hospital course with disseminated Haemophilus influenzae type a infection.
August 26, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28694665/pancreas-preserving-distal-duodenectomy-a-versatile-operation-for-a-range-of-infra-papillary-pathologies
#5
W Kyle Mitchell, Pradeep F Thomas, Abed M Zaitoun, Adam J Brooks, Dileep N Lobo
AIM: To investigate the range of pathologies treated by pancreas preserving distal duodenectomy (PPDD) and present the outcome of follow-up. METHODS: Neoplastic lesions of the duodenum are treated conventionally by pancreaticoduodenectomy. Lesions distal to the major papilla may be suitable for a pancreas-preserving distal duodenectomy, potentially reducing morbidity and mortality. We present our experience with this procedure. Selective intraoperative duodenoscopy assessed the relationship of the papilla to the lesion...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28538505/thalassemia-major-and-priapism-a-case-report-of-an-adolescent
#6
Sibel Öz, Serhan Küpeli, Gülay Sezgin, İbrahim Bayram
Priapism is defined as a prolonged pathologic penile erection without sexual stimulation. In children, priapism secondary to sickle cell disease or hematological malignancy is a frequent condition. Appropriate treatment of priapism varies; the treatment is primarily etiological, conservative management. In the present report, we aimed to present a case of asplenic thalassemia major who developed priapism, improved with hydration and ibuprofen treatment. Clinicians should take into account that priapism can be encountered in patients with thalassemia major...
August 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28503278/conjugate-and-23-valent-pneumococcal-polysaccharide-booster-vaccination-in-asplenic-patients-with-thalassemia-major-a-randomized-clinical-trial-study
#7
Mohammad Sadegh Rezai, Javad Ghaffari, Mohammadreza Mahdavi, Amir Bahari, Shahram Ala
BACKGROUND: Pneumococcal vaccine provides protection against invasive pneumococcal disease in population at risk. This study was conducted to compare the antibody response to 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine in patients with thalassemia major. METHODS: A randomized cross-over clinical trial was performed on 50 asplenic patients with thalassemia major who referred to thalassemia center at Bouali Sina Hospital, Sari, Iran from 2013 to 2014...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28498097/the-asplenic-patient-post-insult-immunocompetence-infection-and-vaccination
#8
REVIEW
Brandon Dionne, Walter Dehority, Meghan Brett, Thomas R Howdieshell
BACKGROUND: Splenic injury can occur through multiple mechanisms and may result in various degrees of residual immunocompetence. Functionally or anatomically asplenic patients are at higher risk for infection, particularly with encapsulated bacteria. Vaccination is recommended to prevent infection with these organisms; however, the recommendations are routinely updated, and vaccine selection and timing are complex. METHODS: Review of the pertinent English-language literature, including the recommendations of the U...
July 2017: Surgical Infections
https://www.readbyqxmd.com/read/28488145/anti-pneumococcal-vaccine-induced-cellular-immune-responses-in-post-traumatic-splenectomized-individuals
#9
Djursun Karasartova, Umut Gazi, Ozgur Tosun, Ayse S Gureser, Ibrahim T Sahiner, Mete Dolapci, Aysegul T Ozkan
PURPOSE: Splenectomy is associated with increased risk of overwhelming post-splenectomy infections despite proper anti-pneumococcal vaccination. As most studies concentrated on vaccination-induced humoral immunity, the cellular immune responses triggered in splenectomized patients are not yet well studied. The present study aims to investigate this area as it can contribute to the development of more effective vaccination strategies. METHODS: Five healthy and 14 splenectomized patients were vaccinated with pneumococcal conjugate polysaccharide vaccine (PCV) followed by pneumococcal polysaccharide vaccine according to the guidelines established by Advisory Committee on Immunization Practices...
May 2017: Journal of Clinical Immunology
https://www.readbyqxmd.com/read/28464987/utilizing-pharmacy-intervention-in-asplenic-patients-to-improve-vaccination-rates
#10
Lindsey Rihtarchik, Claire V Murphy, Kyle Porter, Lisa Mostafavifar
PURPOSE: Asplenic patients are at increased risk for post-splenectomy infection caused by Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type B (Hib), and vaccination rates against these organisms remain low. The purpose of this study was to evaluate vaccination rates before and after implementation of a pharmacist-driven electronic vaccination tracking system. METHODS: This retrospective cohort analysis compared adult splenectomy patients before and after implementation of a pharmacist-driven tracking system with a primary outcome of complete initial vaccination...
April 24, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28425162/a-small-lick-will-sink-a-great-ship-fulminant-septicaemia-after-dog-saliva-wound-treatment-in-an-asplenic-patient
#11
Evi M Morandi, Reinhard Pauzenberger, Christoph Tasch, Ulrich M Rieger, Gerhard Pierer, Gabriel Djedovic
Capnocytophaga canimorsus is a bacterium transmitted through the saliva of dogs. An infection can cause severe sepsis with acral necrosis and is potentially fatal. Here, we report the case of a 41-year-old man who was infected through a wound that was licked by his dog. He went into septic shock with disseminated intravascular coagulation and subsequently lost both lower legs, his nose and all the fingers on both hands.
April 19, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28424248/splenic-ly6g-high-mature-and-ly6g-int-immature-neutrophils-contribute-to-eradication-of-s-pneumoniae
#12
Justin F Deniset, Bas G Surewaard, Woo-Yong Lee, Paul Kubes
The spleen plays an integral protective role against encapsulated bacterial infections. Our understanding of the associated mechanisms is limited to thymus-independent (TI) antibody production by the marginal zone (MZ) B cells, leaving the contribution of other splenic compartments such as the red pulp (RP) largely unexplored despite asplenic patients succumbing to the infection in the first 24 h, suggesting important antibody-independent mechanisms. In this study, using time-lapse intravital imaging of the spleen, we identify a tropism for Streptococcus pneumoniae in this organ mediated by tissue-resident MZ and RP macrophages and a protective role for two distinct splenic neutrophil populations (Ly6G(hi) and Ly6G(intermediate)) residing in the splenic RP...
May 1, 2017: Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28405337/autoimmune-hemolytic-anemia-associated-with-babesiosis
#13
Roshni Narurkar, Aleksandra Mamorska-Dyga, John C Nelson, Delong Liu
BACKGROUND: Babesiosis is endemic in selected areas in North America. Babesia infection is commonly associated with anemia, thrombocytopenia, hyponatremia and elevated liver enzymes. Autoimmune hemolytic anemia (AIHA) is known to be caused by parasitic and viral infections but has not been well characterized. CASE PRESENTATION: We describe two cases diagnosed with babesiosis triggering severe AIHA. One case had history of splenectomy, and the other was an elderly patient...
2017: Biomarker Research
https://www.readbyqxmd.com/read/28381345/vaccination-recommendations-for-the-adult-immunosuppressed-patient-a-systematic-review-and-comprehensive-field-synopsis
#14
REVIEW
Anthony Lopez, Xavier Mariette, Hervé Bachelez, Alexandre Belot, Bernard Bonnotte, Eric Hachulla, Morad Lahfa, Olivier Lortholary, Pierre Loulergue, Stéphane Paul, Xavier Roblin, Jean Sibilia, Mariela Blum, Silvio Danese, Stefanos Bonovas, Laurent Peyrin-Biroulet
BACKGROUND: Immunosuppressed patients are at risk of severe viral infections-related complications. National and international vaccination guidelines have been developed to decrease the mortality risk associated with these infections. However, a summary of these guidelines and the value of immunisation in this population is missing. OBJECTIVES: To summarize specific guidelines regarding vaccination in immunosuppressed patients. METHODS: We performed a literature search based on last update vaccine guidelines in immunosuppressed adult patients published between 1/1/2005-1/31/2016 in English or French language using PubMed, Cochrane and Embase, as well as relevant medical society websites...
June 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28273010/post-babesiosis-warm-autoimmune-hemolytic-anemia
#15
Ann E Woolley, Mary W Montgomery, William J Savage, Maureen O Achebe, Kathleen Dunford, Sarah Villeda, James H Maguire, Francisco M Marty
Background Babesiosis, a tickborne zoonotic disease caused by intraerythrocytic protozoa of the genus babesia, is characterized by nonimmune hemolytic anemia that resolves with antimicrobial treatment and clearance of parasitemia. The development of warm-antibody autoimmune hemolytic anemia (also known as warm autoimmune hemolytic anemia [WAHA]) in patients with babesiosis has not previously been well described. Methods After the observation of sporadic cases of WAHA that occurred after treatment of patients for babesiosis, we conducted a retrospective cohort study of all the patients with babesiosis who were cared for at our center from January 2009 through June 2016...
March 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28213046/splenectomy-as-a-destination-improving-quality-of-care-among-asplenic-veterans-through-a-travel-clinic
#16
Aaron P Mitchell, Joel C Boggan, Karen Lau, David L Simel
BACKGROUND: Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor. The goal of this study was to demonstrate that a targeted intervention can improve vaccination rates in a population of asplenic veterans. METHODS: Surgically asplenic patients actively receiving care in our health care system were identified via a database search. Patients were contacted via mailed letters and encouraged to attend an existing travel clinic with a new process designed for asplenic patients...
July 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/27994385/exchange-transfusion-for-babesiosis-when-how-and-how-long
#17
Pramod K Guru, John C O Horo, Heidi D Lehrke, Jeffrey L Winters, John W Wilson
Babesiosis is a zoonotic disease transmitted by Ixodes ticks seen in the United States and parts of Europe. Because of the typically mild course of most infections, the disease is uncommonly seen in clinical practice. However, asplenic patients can develop a life-threatening infection. The first line of therapy for Babesia infections is antiparasitic medications; however, red blood cell (RBC) exchange transfusion has been described as an adjunct therapy. We describe a severe case of babesiosis in an asplenic patient and review the evidence, indications, and protocols for RBC exchange transfusion in this setting...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27929751/recommended-vaccinations-for-asplenic-and-hyposplenic-adult-patients
#18
REVIEW
Paolo Bonanni, Maddalena Grazzini, Giuditta Niccolai, Diana Paolini, Ornella Varone, Alessandro Bartoloni, Filippo Bartalesi, Maria Grazia Santini, Simonetta Baretti, Carlo Bonito, Paola Zini, Maria Teresa Mechi, Fabrizio Niccolini, Lea Magistri, Maria Beatrice Pulci, Sara Boccalini, Angela Bechini
Asplenic or hyposplenic (AH) individuals are particularly vulnerable to invasive infections caused by encapsulated bacteria. Such infections have often a sudden onset and a fulminant course. Infectious diseases (IDs) incidence in AH subjects can be reduced by preventive measures such as vaccination. The aim of our work is to provide updated recommendations on prevention of infectious diseases in AH adult patients, and to supply a useful and practical tool to healthcare workers for the management of these subjects, in hospital setting and in outpatients consultation...
February 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/27819637/patients-after-splenectomy-old-risks-and-new-perspectives
#19
REVIEW
Mihnea Dragomir, Dragoş George Emil Petrescu, Graţiela Elena Manga, George A Călin, Cătălin Vasilescu
The risks that arise after splenectomy can be divided in infectious and non-infectious. The link between splenectomy and these hazards remains partially unknown. Host defense against infection is altered after splenectomy and such individuals develop sepsis more easily and the infection has a fulminant course. Splenectomy is also a potential risk factor for several vascular complications that result from partial or total obstruction of an arterial or venous blood vessel. Furthermore, pulmonary hypertensioncan be a severe and sometimes fatal complication following splenectomy...
2016: Chirurgia
https://www.readbyqxmd.com/read/27776576/overwhelming-post-splenectomy-sepsis-in-patients-with-asplenia-and-hyposplenia-a-retrospective-cohort-study
#20
J Chong, P Jones, D Spelman, K Leder, A C Cheng
Overwhelming post-splenectomy infection (OPSI) is a serious complication of asplenia and is associated with encapsulated organisms, most commonly Streptococcus pneumoniae, but also Haemophilus influenzae and Neisseria meningitidis. We aimed to estimate the risk of infection in this patient group. We reviewed data collected by the Victorian Spleen Registry in Australia. On registration, all patients are asked about significant infections requiring admission to hospital for intravenous antibiotics; those requiring admission to ICU were defined as OPSI...
January 2017: Epidemiology and Infection
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