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The Impact of Glucose-6-Phosphate Dehydrogenase Deficiency on the Frequency of Vasoocclusive Crisis in Patients with Sickle Cell Anemia 葡萄糖-6-磷酸脱氢酶缺乏对镰状细胞性贫血患者血管闭塞危象发生频率的影响
IF 0.3 Q4 HEMATOLOGY Pub Date : 2021-03-01 DOI: 10.1177/26348535211040528
Hilary Igwilo, L. Salawu, Tewogbade Adeoye Adedeji
Background and Objectives Sickle cell anemia (SCA) and glucose-6-phosphate dehydrogenase (G6PD) deficiency are both hereditary diseases of the red blood cells that cause hemolysis. The impact of the interaction of both conditions on the clinical and laboratory presentations of the affected persons is sparse. This study, therefore, correlated G6PD activity with disease severity in persons with SCA by comparing disease severity in G6PD-deficient SCA persons with those with normal G6PD activity. Methodology This cross-sectional study was conducted in the department of Haematology and Blood Transfusion of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. G6PD activity, SCA disease severity, and hematological parameters including reticulocyte counts and Heinz body estimation, bilirubin, and aspartate transaminase were estimated in 67 SCA persons. The results were compared between SCA persons with G6PD deficiency and those with normal enzyme activity. Results The prevalence of G6PD deficiency was found to be 23.9%. The G6PD-deficient SCA patients included 4 (25.0%) males and 12 (75.0%) females. G6PD deficiency was significantly higher in females (P = .047). There was no significant difference in disease severity scores between G6PD-deficient and G6PD-nondeficient SCA patients. However, G6PD-deficient persons reported significantly higher episodes of severe vasoocclusive crisis (VOC) per annum (P = .048). The hematological and biochemical parameters were similar between G6PD-deficient and G6PD normal SCA persons except that the G6PD-deficient SCA persons have significantly higher reticulocyte response (P = .001). There was no correlation between disease severity resulting from reduced G6PD activity and Heinz body formation in SCA persons in the steady state. Conclusion G6PD deficiency significantly contributes to recurrent painful vasoocclusive crisis in SCA persons in the steady state.
背景与目的镰状细胞性贫血(SCA)和葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症都是导致溶血的遗传性红细胞疾病。这两种情况的相互作用对临床和实验室表现的影响是稀疏的。因此,本研究通过比较G6PD缺乏的SCA患者与G6PD活性正常的SCA患者的疾病严重程度,将G6PD活性与SCA患者的疾病严重程度联系起来。这项横断面研究是在尼日利亚Ile-Ife奥巴费米·阿沃洛沃大学教学医院综合医院的血液学和输血科进行的。对67例SCA患者的G6PD活性、SCA疾病严重程度和血流变参数(包括网状红细胞计数、亨氏体估计、胆红素和天冬氨酸转氨酶)进行了评估。将G6PD缺乏症SCA患者与酶活性正常的SCA患者进行比较。结果G6PD缺乏症患病率为23.9%。g6pd缺陷SCA患者中男性4例(25.0%),女性12例(75.0%)。G6PD缺乏症在女性中明显更高(P = 0.047)。g6pd缺陷和g6pd非缺陷SCA患者的疾病严重程度评分无显著差异。然而,g6pd缺陷者每年报告的严重血管闭合性危象(VOC)发生率明显更高(P = 0.048)。G6PD缺乏症SCA患者血液学和生化指标与G6PD正常SCA患者相似,但G6PD缺乏症SCA患者网状细胞反应明显高于正常SCA患者(P = 0.001)。SCA患者在稳定状态下,G6PD活性降低导致的疾病严重程度与亨氏体形成之间没有相关性。结论G6PD缺乏对SCA患者稳定状态下复发性疼痛性血管闭合性危像有重要影响。
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引用次数: 5
The Development of Transfusion-Related Acute Lung Injury for the Second Time: A New Awareness for Daratumumab? 第二次输血相关急性肺损伤的发展:对达拉单抗的新认识?
IF 0.3 Q4 HEMATOLOGY Pub Date : 2021-03-01 DOI: 10.1177/26348535211038276
A. Turgutkaya, A. Bolaman, I. Yavaşoğlu
Transfusion-related acute lung injury (TRALI) is an undesired and potentially fatal complication of blood transfusion. Besides human neutrophil and leukocyte antigens of the donor blood; especially for red blood cell transfusions, nonantibody-mediated mechanisms seem responsible. Among these patients, pulmonary neutrophils have increased sensitivity to initiate TRALI. It is a very rare event for a patient to develop a second reaction. Comorbid conditions such as kidney failure and cardiovascular diseases may pose a risk. Daratumumab, an anti-CD38 monoclonal antibody, seems unrelated because it only causes indirect Coombs positivity without triggering transfusion complications. However, its role in recipient–donor interactions causing TRALI is less clear. Here, we report a relapsed multiple myeloma-diagnosed patient who developed TRALI under daratumumab treatment.
输血相关急性肺损伤(TRALI)是一种不希望发生的、可能致命的输血并发症。除供血人中性粒细胞和白细胞抗原外;尤其是红细胞输注,非抗体介导的机制似乎起了作用。在这些患者中,肺中性粒细胞对启动TRALI的敏感性增加。病人出现第二次反应是非常罕见的。合并症如肾衰竭和心血管疾病可能会造成风险。抗cd38单克隆抗体Daratumumab似乎与此无关,因为它只导致间接库姆斯阳性,而不会引发输血并发症。然而,它在引起TRALI的受体-供体相互作用中的作用尚不清楚。在这里,我们报告了一位复发的多发性骨髓瘤诊断患者,他在达拉单抗治疗下发生了TRALI。
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引用次数: 0
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Plasmatology
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