Acute myeloid leukemia (AML) is associated with particularly poor outcomes in the elderly population, in whom the disease is most prevalent. BCL-2 has been identified as an antiapoptotic protein and promotes survival of leukemia stem cells. Recently, the United States FDA has approved venetoclax, a selective oral BCL-2 inhibitor, for use in conjunction with hypomethylating agents (azacitidine or decitabine) or low-dose cytarabine as a first-line treatment option for those AML patients ineligible for standard induction chemotherapy. However, there are nuances and challenges when using this regimen in the extremely elderly AML patients. Given the widespread adoption of this regimen and increasing prevalence of patients who are well into their 80 s, it is important to evaluate and understand how to safely use this regimen in this so-called “extremely elderly” population. We present here 3 case studies involving AML patients >85 years of age who were treated with venetoclax plus HMA and provide clinical knowledge on how this population should be appropriately managed.
{"title":"Age-Adjusted Schedules of Venetoclax and Hypomethylating Agents to Treat Extremely Elderly Patients with Acute Myeloid Leukemia","authors":"Aaron M. Lee, A. Goodman, J. Mangan","doi":"10.1155/2022/2802680","DOIUrl":"https://doi.org/10.1155/2022/2802680","url":null,"abstract":"Acute myeloid leukemia (AML) is associated with particularly poor outcomes in the elderly population, in whom the disease is most prevalent. BCL-2 has been identified as an antiapoptotic protein and promotes survival of leukemia stem cells. Recently, the United States FDA has approved venetoclax, a selective oral BCL-2 inhibitor, for use in conjunction with hypomethylating agents (azacitidine or decitabine) or low-dose cytarabine as a first-line treatment option for those AML patients ineligible for standard induction chemotherapy. However, there are nuances and challenges when using this regimen in the extremely elderly AML patients. Given the widespread adoption of this regimen and increasing prevalence of patients who are well into their 80 s, it is important to evaluate and understand how to safely use this regimen in this so-called “extremely elderly” population. We present here 3 case studies involving AML patients >85 years of age who were treated with venetoclax plus HMA and provide clinical knowledge on how this population should be appropriately managed.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89676964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Primary involvement of the skeletal muscle by extracavitary primary effusion lymphoma (PEL) is an extremely rare phenomenon. We report an unusual case of PEL involving the jugulodigastric skeletal muscle without serous cavity involvement which resulted in complete occlusion of the ipsilateral proximal internal jugular vein, causing the patient to present with clinical features of intractable throbbing headache, photophobia, acute confusion state, sporadic syncopal attacks, and dyspnea without obvious palpable neck swellings. This led to an initial clinical suspicion, dedicated diagnostic workup, and empiric therapy for acute meningoencephalitis, severe atypical pneumonia, and acute pulmonary embolism. Owing to his refractory symptoms, exploratory CT imaging eventually revealed a heterogenous jugulodigastric mass, and finally, a pathologic diagnosis of extracavitary PEL was identified as the cause of his intracranial hypertension. The patient remains in remission 22 months after commencing a dolutegravir-based HAART regimen without any chemotherapeutic intervention.
{"title":"An Unusual Presentation of Extracavitary Primary Effusion Lymphoma: Internal Jugular Vein Occlusion, Intractable Symptoms of Intracranial Hypertension, and Prolonged Remission after Highly Active Antiretroviral Therapy","authors":"Anindita Ghosh, R. Zvavanjanja, J. Baalwa","doi":"10.1155/2022/6046783","DOIUrl":"https://doi.org/10.1155/2022/6046783","url":null,"abstract":"Primary involvement of the skeletal muscle by extracavitary primary effusion lymphoma (PEL) is an extremely rare phenomenon. We report an unusual case of PEL involving the jugulodigastric skeletal muscle without serous cavity involvement which resulted in complete occlusion of the ipsilateral proximal internal jugular vein, causing the patient to present with clinical features of intractable throbbing headache, photophobia, acute confusion state, sporadic syncopal attacks, and dyspnea without obvious palpable neck swellings. This led to an initial clinical suspicion, dedicated diagnostic workup, and empiric therapy for acute meningoencephalitis, severe atypical pneumonia, and acute pulmonary embolism. Owing to his refractory symptoms, exploratory CT imaging eventually revealed a heterogenous jugulodigastric mass, and finally, a pathologic diagnosis of extracavitary PEL was identified as the cause of his intracranial hypertension. The patient remains in remission 22 months after commencing a dolutegravir-based HAART regimen without any chemotherapeutic intervention.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82926840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hesham Yasin, Tessa Laytem, G. Sutamtewagul, S. Ayyappan
Acute febrile neutrophilic dermatosis which is referred as Sweet's syndrome (SS) is a dermatological condition characterized by fever, erythematous rash, and leukocytosis. SS can be idiopathic or associated with malignancies or medications. We present a rare case of SS which developed shortly after starting midostaurin in a patient with acute myelogenous leukemia (AML).
{"title":"A Rare Case of Midostaurin-Associated Sweet's Syndrome","authors":"Hesham Yasin, Tessa Laytem, G. Sutamtewagul, S. Ayyappan","doi":"10.1155/2022/1099005","DOIUrl":"https://doi.org/10.1155/2022/1099005","url":null,"abstract":"Acute febrile neutrophilic dermatosis which is referred as Sweet's syndrome (SS) is a dermatological condition characterized by fever, erythematous rash, and leukocytosis. SS can be idiopathic or associated with malignancies or medications. We present a rare case of SS which developed shortly after starting midostaurin in a patient with acute myelogenous leukemia (AML).","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81291687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Mayer, N. Srinivasan, J. Nguyen, R. Spilman, D. Scherbak
Herein, we present a unique case of a Coombs-negative, steroid-refractory autoimmune hemolytic anemia (AIHA) complicated by pseudoreticulopenia, describe its clinical presentation, histopathologic findings, and management, and review the salient literature. Coombs-negative, steroid-refractory AIHAs represent fewer than 1% of all AIHAs. Diagnosis of the disease is difficult and often delayed due to the pursuit of alternate diagnoses following a negative Coombs test. However, when suspicion remains high for an autoimmune process, the super-Coombs test may be utilized for the diagnosis of AIHA that the traditional Coombs test fails to detect. A majority of cases respond to rituximab as the indicated second-line therapy, but delays in diagnosis and subsequent treatment may increase morbidity. Reticulopenia may be associated with AIHAs secondary to bone marrow dysfunction, but this patient had a normal function marrow confirmed on biopsy. Indeed, reticulopenia in this case was a diagnostic conundrum that further obscured the diagnosis and delayed treatment. Ultimately, reticulopenia was determined to be pseudoreticulopenia secondary to an alteration in the maturation of the erythroid lineage due to an independent, newly diagnosed pernicious anemia. The interaction of these multiple coexisting disease processes is not previously described in the literature. Increased physician awareness of steroid-refractory, Coombs-negative AIHA, and the development of pseudoreticulopenia as a laboratory finding in pernicious anemia may help to improve patient outcomes.
{"title":"A Curious Case of Hemolytic Anemia with Pseudoreticulopenia","authors":"S. Mayer, N. Srinivasan, J. Nguyen, R. Spilman, D. Scherbak","doi":"10.1155/2022/6423143","DOIUrl":"https://doi.org/10.1155/2022/6423143","url":null,"abstract":"Herein, we present a unique case of a Coombs-negative, steroid-refractory autoimmune hemolytic anemia (AIHA) complicated by pseudoreticulopenia, describe its clinical presentation, histopathologic findings, and management, and review the salient literature. Coombs-negative, steroid-refractory AIHAs represent fewer than 1% of all AIHAs. Diagnosis of the disease is difficult and often delayed due to the pursuit of alternate diagnoses following a negative Coombs test. However, when suspicion remains high for an autoimmune process, the super-Coombs test may be utilized for the diagnosis of AIHA that the traditional Coombs test fails to detect. A majority of cases respond to rituximab as the indicated second-line therapy, but delays in diagnosis and subsequent treatment may increase morbidity. Reticulopenia may be associated with AIHAs secondary to bone marrow dysfunction, but this patient had a normal function marrow confirmed on biopsy. Indeed, reticulopenia in this case was a diagnostic conundrum that further obscured the diagnosis and delayed treatment. Ultimately, reticulopenia was determined to be pseudoreticulopenia secondary to an alteration in the maturation of the erythroid lineage due to an independent, newly diagnosed pernicious anemia. The interaction of these multiple coexisting disease processes is not previously described in the literature. Increased physician awareness of steroid-refractory, Coombs-negative AIHA, and the development of pseudoreticulopenia as a laboratory finding in pernicious anemia may help to improve patient outcomes.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85391019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maryam Mehdipour Dalivand, Parastou Tizro, Julie Partain, A. Aggarwal, J. Lichy, Francisco Mot Ara, V. Nava
Although acute lymphoblastic leukemia (ALL) and monoclonal B cell lymphocytosis (MBL) are common neoplasia, a simultaneous presentation is very unusual. Here, we present two different B cell clones, MBL and B-ALL, cocirculating in a 78-year-old African American male. Detailed molecular characterization revealed an unusual MPL (T487I) point mutation and unmutated VH4-39. After nonstandard chemotherapy, the patient remains in morphologic remission. These findings may stimulate further research to clarify the pathogenesis of hematologic neoplasms.
{"title":"Concurrent B Cell Acute Lymphoblastic Lymphoma/Leukemia and Monoclonal B Cell Lymphocytosis: A Case Report with Extensive Molecular Analysis","authors":"Maryam Mehdipour Dalivand, Parastou Tizro, Julie Partain, A. Aggarwal, J. Lichy, Francisco Mot Ara, V. Nava","doi":"10.1155/2022/1132544","DOIUrl":"https://doi.org/10.1155/2022/1132544","url":null,"abstract":"Although acute lymphoblastic leukemia (ALL) and monoclonal B cell lymphocytosis (MBL) are common neoplasia, a simultaneous presentation is very unusual. Here, we present two different B cell clones, MBL and B-ALL, cocirculating in a 78-year-old African American male. Detailed molecular characterization revealed an unusual MPL (T487I) point mutation and unmutated VH4-39. After nonstandard chemotherapy, the patient remains in morphologic remission. These findings may stimulate further research to clarify the pathogenesis of hematologic neoplasms.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83352691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexis Lordi, N. Ansari, M. Maroules, Anusha Manjegowda
Splenomegaly is manifested by a variety of etiologies, one of which is macrocytic anemia. Macrocytic anemia has multiple causes in itself that include; folate (Vitamin B9) and Cobalamin (vitamin B12) deficiencies. In this case report, we present a patient with a history of pancytopenia, macrocytic anemia and vitamin B12 deficiency, who underwent a splenectomy. The differential diagnoses for the cause of the patient's splenomegaly included: lymphoma, infiltrative disease, and idiopathic splenomegaly. The pathology report from the splenectomy did not reveal any evidence of lymphoma or infiltrative disease, however, it did mention vascular congestion of the spleen. In theory, vascular congestion, due to extramedullary hematopoiesis in the spleen or sequestration of blood cell lineages, could lead to pancytopenia. In prior visits to the hospital this patient was diagnosed with: splenomegaly, and macrocytic anemia due to pernicious anemia. A splenectomy puts one at increased risk for infection by encapsulated organisms, and is to be avoided if possible. There are few case reports and studies that show vitamin B12 therapy can potentially cause a reversal in the splenomegaly as well as a reversal in the pancytopenia and macrocytic anemia. We hope to show that the least invasive treatment for vitamin B12, vitamin therapy, can be of use and effective.
{"title":"Splenomegaly in a Patient with a History of Pernicious Anemia; the Potential Therapeutic Effects of B12 Therapy","authors":"Alexis Lordi, N. Ansari, M. Maroules, Anusha Manjegowda","doi":"10.1155/2022/2854520","DOIUrl":"https://doi.org/10.1155/2022/2854520","url":null,"abstract":"Splenomegaly is manifested by a variety of etiologies, one of which is macrocytic anemia. Macrocytic anemia has multiple causes in itself that include; folate (Vitamin B9) and Cobalamin (vitamin B12) deficiencies. In this case report, we present a patient with a history of pancytopenia, macrocytic anemia and vitamin B12 deficiency, who underwent a splenectomy. The differential diagnoses for the cause of the patient's splenomegaly included: lymphoma, infiltrative disease, and idiopathic splenomegaly. The pathology report from the splenectomy did not reveal any evidence of lymphoma or infiltrative disease, however, it did mention vascular congestion of the spleen. In theory, vascular congestion, due to extramedullary hematopoiesis in the spleen or sequestration of blood cell lineages, could lead to pancytopenia. In prior visits to the hospital this patient was diagnosed with: splenomegaly, and macrocytic anemia due to pernicious anemia. A splenectomy puts one at increased risk for infection by encapsulated organisms, and is to be avoided if possible. There are few case reports and studies that show vitamin B12 therapy can potentially cause a reversal in the splenomegaly as well as a reversal in the pancytopenia and macrocytic anemia. We hope to show that the least invasive treatment for vitamin B12, vitamin therapy, can be of use and effective.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80061901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stamatios Chrysochoou, A. Kreft, Eberhard Schneider
RationalCastleman disease is a rare lymphoproliferative disorder that can be subdivided into unicentric and multicentric forms, the latter of which causes a spectrum of serious medical conditions. Here, we present a case of idiopathic multicentric Castleman disease in the eighth decade of life. Patient Concerns. First hospitalized due to unexplained progressive anemia, the patient was readmitted to the hospital 18 months later with suspected lymphoma. Clinical examination revealed a progressive lymphadenopathy. Diagnoses. Histopathologic lymph node features, anemia, elevated CRP and IL6 levels, splenomegaly, and hypoalbuminemia indicated multicentric Castleman (MCD) disease. Interventions. The patient was treated intravenously with a dose of 11 mg/kg siltuximab every 3 weeks. Outcomes. Timely correct diagnosis through the stringent use of consensus diagnostic criteria and sufficient siltuximab therapy has considerably promoted favorable clinical outcomes in a patient suffering from MCD.
{"title":"Siltuximab-Related Favorable Clinical Outcome for a Patient Suffering from Idiopathic Multicentric Castleman Disease","authors":"Stamatios Chrysochoou, A. Kreft, Eberhard Schneider","doi":"10.1155/2022/1840589","DOIUrl":"https://doi.org/10.1155/2022/1840589","url":null,"abstract":"RationalCastleman disease is a rare lymphoproliferative disorder that can be subdivided into unicentric and multicentric forms, the latter of which causes a spectrum of serious medical conditions. Here, we present a case of idiopathic multicentric Castleman disease in the eighth decade of life. Patient Concerns. First hospitalized due to unexplained progressive anemia, the patient was readmitted to the hospital 18 months later with suspected lymphoma. Clinical examination revealed a progressive lymphadenopathy. Diagnoses. Histopathologic lymph node features, anemia, elevated CRP and IL6 levels, splenomegaly, and hypoalbuminemia indicated multicentric Castleman (MCD) disease. Interventions. The patient was treated intravenously with a dose of 11 mg/kg siltuximab every 3 weeks. Outcomes. Timely correct diagnosis through the stringent use of consensus diagnostic criteria and sufficient siltuximab therapy has considerably promoted favorable clinical outcomes in a patient suffering from MCD.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72475451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osama N. Dukmak, Hamzeh M. I. Abugharbieh, Mohammad Emar, Iman Khamayseh, Salem M. Tos, Rafiq Salhab
Background Appendiceal lymphoma is a very rare entity accounting for 0.015% of all gastrointestinal lymphoma cases. Acute appendicitis is the most common presentation of primary appendix neoplasms. Burkitt's lymphoma presenting as an acute appendicitis is a rare entity with around 21% of the cases presenting as a lower iliac fossa mass. Case Presentation. A 23-year-old male was admitted to the surgical ward as a case of acute appendicitis with localized tenderness in the right iliac fossa, positive rebound tenderness, a positive Rovsing's sign, and ultrasound findings of suspected complicated appendicitis. Appendectomy was performed. Histopathological examination of the appendectomy specimen revealed a double-expressor non-Hodgkin diffuse large cell lymphoma with Burkitt's-like morphology. He was sent for chemotherapy treatment. Conclusion Only 34 cases of Burkitt's lymphoma have been reported to present as acute appendicitis. Histological examination following appendectomy for an apparent appendicitis is essential. Furthermore, complete blood count and a computed tomography scan aid the diagnosis of lymphoma. Double-expressor lymphoma has been shown to have poor outcomes. Therefore, prompt and aggressive treatment is vital.
{"title":"Double-Expressor Appendiceal Burkitt's Lymphoma: A Case Report and Literature Review","authors":"Osama N. Dukmak, Hamzeh M. I. Abugharbieh, Mohammad Emar, Iman Khamayseh, Salem M. Tos, Rafiq Salhab","doi":"10.1155/2022/6795699","DOIUrl":"https://doi.org/10.1155/2022/6795699","url":null,"abstract":"Background Appendiceal lymphoma is a very rare entity accounting for 0.015% of all gastrointestinal lymphoma cases. Acute appendicitis is the most common presentation of primary appendix neoplasms. Burkitt's lymphoma presenting as an acute appendicitis is a rare entity with around 21% of the cases presenting as a lower iliac fossa mass. Case Presentation. A 23-year-old male was admitted to the surgical ward as a case of acute appendicitis with localized tenderness in the right iliac fossa, positive rebound tenderness, a positive Rovsing's sign, and ultrasound findings of suspected complicated appendicitis. Appendectomy was performed. Histopathological examination of the appendectomy specimen revealed a double-expressor non-Hodgkin diffuse large cell lymphoma with Burkitt's-like morphology. He was sent for chemotherapy treatment. Conclusion Only 34 cases of Burkitt's lymphoma have been reported to present as acute appendicitis. Histological examination following appendectomy for an apparent appendicitis is essential. Furthermore, complete blood count and a computed tomography scan aid the diagnosis of lymphoma. Double-expressor lymphoma has been shown to have poor outcomes. Therefore, prompt and aggressive treatment is vital.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80411975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jorge D. Guerra, Jasmine Gowarty, Jordan Buess, James Mason, K. Halka
Acquired Hemophilia A (AHA) is a very rare autoimmune condition involving immune-mediated depletion of Factor VIII, resulting in spontaneous hemorrhage. Failure to recognize AHA as a possible etiology of hemorrhage can result in delayed diagnosis and treatment. The COVID-19 pandemic has given rise to several hematologic conditions and complications, with a rare manifestation being Acquired Hemophilia A (AHA). An interesting case of AHA following SARS-CoV-2 infection is described, along with the treatment approach and a brief review of several cases describing AHA in association with COVID-19.
{"title":"A Case of Acquired Hemophilia A in a Patient with Exposure to COVID-19","authors":"Jorge D. Guerra, Jasmine Gowarty, Jordan Buess, James Mason, K. Halka","doi":"10.1155/2022/9494249","DOIUrl":"https://doi.org/10.1155/2022/9494249","url":null,"abstract":"Acquired Hemophilia A (AHA) is a very rare autoimmune condition involving immune-mediated depletion of Factor VIII, resulting in spontaneous hemorrhage. Failure to recognize AHA as a possible etiology of hemorrhage can result in delayed diagnosis and treatment. The COVID-19 pandemic has given rise to several hematologic conditions and complications, with a rare manifestation being Acquired Hemophilia A (AHA). An interesting case of AHA following SARS-CoV-2 infection is described, along with the treatment approach and a brief review of several cases describing AHA in association with COVID-19.","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88196343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-22eCollection Date: 2022-01-01DOI: 10.1155/2022/8271069
Michael Youssef, Tyler W Stratton, Reid C Gallant, Christine Young, Daniel Y Li, Siavash Piran
We report a case of pure white cell aplasia (PWCA) postthymoma resection in a 74-year-old male presenting with a 2-week history of fevers, night sweats, and severe febrile neutropenia. His pure white cell aplasia was treated with intravenous immunoglobulin (IVIg), granulocyte colony-stimulating factor (G-CSF), prednisone, and cyclosporine with a mixed response. He also developed immune thrombocytopenia, which responded well to a short course of eltrombopag. With continued cyclosporine treatment, his platelet counts were stable after stopping eltrombopag. The patient's cyclosporine treatment was complicated by renal failure, resulting in cessation of cyclosporine. His PWCA and immune thrombocytopenia significantly worsened after stopping cyclosporine, and unfortunately, he died from multiorgan failure and sepsis.
{"title":"Pure White Cell Aplasia and Immune Thrombocytopenia after Thymoma Resection: A Case Report and Review of the Literature.","authors":"Michael Youssef, Tyler W Stratton, Reid C Gallant, Christine Young, Daniel Y Li, Siavash Piran","doi":"10.1155/2022/8271069","DOIUrl":"10.1155/2022/8271069","url":null,"abstract":"<p><p>We report a case of pure white cell aplasia (PWCA) postthymoma resection in a 74-year-old male presenting with a 2-week history of fevers, night sweats, and severe febrile neutropenia. His pure white cell aplasia was treated with intravenous immunoglobulin (IVIg), granulocyte colony-stimulating factor (G-CSF), prednisone, and cyclosporine with a mixed response. He also developed immune thrombocytopenia, which responded well to a short course of eltrombopag. With continued cyclosporine treatment, his platelet counts were stable after stopping eltrombopag. The patient's cyclosporine treatment was complicated by renal failure, resulting in cessation of cyclosporine. His PWCA and immune thrombocytopenia significantly worsened after stopping cyclosporine, and unfortunately, he died from multiorgan failure and sepsis.</p>","PeriodicalId":46307,"journal":{"name":"Case Reports in Hematology","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76761366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：