Pub Date : 2017-01-31DOI: 10.15406/MOJI.2017.05.00147
Sachin K. Samuchiwal
Submit Manuscript | http://medcraveonline.com responsible for the substandard efficacy of BCG [2]. Considerable efforts are being made to generate recombinant BCG (rBCG) but with little headway. Causative agent of TB Mycobacterium tuberculosis (M.tb) is remarkably skillful in eluding host defense and modulating immune response for its own benefits. An interesting approach for combating TB is to target M.tb virulence factors [3]. One such key protein is ESAT-6, encoded by region of difference 1 (RD1), the region absent from BCG and most attenuated mycobacterial strains [4,5].
{"title":"ESAT-6: A Perfect Warfare or A Weak Link in Armor","authors":"Sachin K. Samuchiwal","doi":"10.15406/MOJI.2017.05.00147","DOIUrl":"https://doi.org/10.15406/MOJI.2017.05.00147","url":null,"abstract":"Submit Manuscript | http://medcraveonline.com responsible for the substandard efficacy of BCG [2]. Considerable efforts are being made to generate recombinant BCG (rBCG) but with little headway. Causative agent of TB Mycobacterium tuberculosis (M.tb) is remarkably skillful in eluding host defense and modulating immune response for its own benefits. An interesting approach for combating TB is to target M.tb virulence factors [3]. One such key protein is ESAT-6, encoded by region of difference 1 (RD1), the region absent from BCG and most attenuated mycobacterial strains [4,5].","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47678320","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 : 2017-01-31DOI: 10.15406/moji.2016.05.00147
S. SachinKumar
{"title":"ESAT-6: A Perfect Warfare or A Weak Link in Armor","authors":"S. SachinKumar","doi":"10.15406/moji.2016.05.00147","DOIUrl":"https://doi.org/10.15406/moji.2016.05.00147","url":null,"abstract":"","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44809097","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 : 2017-01-31DOI: 10.15406/MOJI.2017.05.00148
J. Sánchez-Ibáñez
MOJ Immunol 2017, 5(1): 00148 of general practice consultations for musculoskeletal pain are related to tendon disorders [1]. Tendon injury can affect people of all ages, and can impair the activity of young and old adults in their work environment or sports activities. In summary, tendon disorders are common, have a substantial effect on quality of life and represent an important economic burden on health care systems [2].
{"title":"A Molecular Mechanisms of Regeneration in Chronic Tendinopathy Using Ultrasound-Guided Intratissue Percutaneous Electrolysis (EPI®)","authors":"J. Sánchez-Ibáñez","doi":"10.15406/MOJI.2017.05.00148","DOIUrl":"https://doi.org/10.15406/MOJI.2017.05.00148","url":null,"abstract":"MOJ Immunol 2017, 5(1): 00148 of general practice consultations for musculoskeletal pain are related to tendon disorders [1]. Tendon injury can affect people of all ages, and can impair the activity of young and old adults in their work environment or sports activities. In summary, tendon disorders are common, have a substantial effect on quality of life and represent an important economic burden on health care systems [2].","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47511206","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 : 2017-01-24DOI: 10.15406/MOJI.2017.05.00146
Richa Rathor, D. Meena, R. Shyam, K. Misra
Wheatgrass, Triticum aestivumis well known for its high nutritional values. However the immunomodulatory activity of the same is unexplored. Therefore, the present study was planned to elucidate the immunomodulatory activity of aqueous and hydro-ethanolic extract of wheatgrass. For immunomodulatory activity analysis, THP1 cells were treated with and without lipopolysaccharide (LPS) and aqueous and hydroethanolic wheatgrass extract (50µg/mL and 100µg/mL, respectively) for 24 h. After 24 h, supernatants were harvested and cytokine assays were performed. NO production in terms of amount of nitritecontent was also estimated in treated and untreated murine peritoneal macrophages using Griess reagent. Further, a dose dependent in-vitrocomparative study concluded that both the extracts possess immunostimulatory activity. However comparison between both established that aqueous extract of wheatgrass having more immunostimulatory activity at the dose of 100μg/ml as extract significantly upregulated LPS induced release of TNF-α, IL-1β and IL-6 in THP1 cells. The extract also significantly induced nitrite release in macrophage cells without causing any toxic effects. The findings suggest the non-specific immunostimulatory activity of wheatgrass; hence it could be used in enhancing immune responses and disease resistance.
{"title":"Immunostimulatory Activity Investigation of Aqueous and Hydroethanolic Extract of Wheatgrass Using THP1 Cells","authors":"Richa Rathor, D. Meena, R. Shyam, K. Misra","doi":"10.15406/MOJI.2017.05.00146","DOIUrl":"https://doi.org/10.15406/MOJI.2017.05.00146","url":null,"abstract":"Wheatgrass, Triticum aestivumis well known for its high nutritional values. However the immunomodulatory activity of the same is unexplored. Therefore, the present study was planned to elucidate the immunomodulatory activity of aqueous and hydro-ethanolic extract of wheatgrass. For immunomodulatory activity analysis, THP1 cells were treated with and without lipopolysaccharide (LPS) and aqueous and hydroethanolic wheatgrass extract (50µg/mL and 100µg/mL, respectively) for 24 h. After 24 h, supernatants were harvested and cytokine assays were performed. NO production in terms of amount of nitritecontent was also estimated in treated and untreated murine peritoneal macrophages using Griess reagent. Further, a dose dependent in-vitrocomparative study concluded that both the extracts possess immunostimulatory activity. However comparison between both established that aqueous extract of wheatgrass having more immunostimulatory activity at the dose of 100μg/ml as extract significantly upregulated LPS induced release of TNF-α, IL-1β and IL-6 in THP1 cells. The extract also significantly induced nitrite release in macrophage cells without causing any toxic effects. The findings suggest the non-specific immunostimulatory activity of wheatgrass; hence it could be used in enhancing immune responses and disease resistance.","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44615929","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 : 2017-01-12DOI: 10.15406/MOJI.2017.05.00143
W. Al-Hamadany
Immune response against OM infections depends mainly on Humoral mediated Immunity (HMI). From this scientific fact, the present study took care with the estimation of some immunological parameters related to these infections immunological response. Total W.B.C.s count was estimated. Furthermore Radial Immune Diffusion (RID) method was used in determination of Immunoglubulins IgG, IgM and IgA; also complement components C3 and C4 levels were estimated using Endoplate kits too. Results: OM Infections resultant from gram positive cocci increased total W.B.Cs counts, IgG, IgM, IgA, C3 and C4 complement components levels; in non-immunologicaly compromised patients comparing with the values of the peoples of control groups for all the parameters that estimated. Conclusions: Otitis media is a common infection in both children and adults. Gram positive suppurative OM caused; significant elevations in Total W.B.C.s counts, Immunoglubulins IgG, IgM and IgA and the complement components C3 and C4. Since HMI is the immunological response against these infections.
{"title":"Estimation of Some Immunoglobulins Classes and Innate Immunity Parameters in BOM Cases","authors":"W. Al-Hamadany","doi":"10.15406/MOJI.2017.05.00143","DOIUrl":"https://doi.org/10.15406/MOJI.2017.05.00143","url":null,"abstract":"Immune response against OM infections depends mainly on Humoral mediated Immunity (HMI). From this scientific fact, the present study took care with the estimation of some immunological parameters related to these infections immunological response. Total W.B.C.s count was estimated. Furthermore Radial Immune Diffusion (RID) method was used in determination of Immunoglubulins IgG, IgM and IgA; also complement components C3 and C4 levels were estimated using Endoplate kits too. Results: OM Infections resultant from gram positive cocci increased total W.B.Cs counts, IgG, IgM, IgA, C3 and C4 complement components levels; in non-immunologicaly compromised patients comparing with the values of the peoples of control groups for all the parameters that estimated. Conclusions: Otitis media is a common infection in both children and adults. Gram positive suppurative OM caused; significant elevations in Total W.B.C.s counts, Immunoglubulins IgG, IgM and IgA and the complement components C3 and C4. Since HMI is the immunological response against these infections.","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42582922","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 : 2017-01-01Epub Date: 2017-02-08DOI: 10.15406/moji.2017.05.00149
Murli Manohar, Alok K Verma, Sathisha Upparahalli Venkateshaiah, Nathan L Sanders, Anil Mishra
Pancreatitis is a condition characterized by parenchymal inflammation of the pancreas, which is often associated with lung injury due to low level of oxygen and the condition is termed as acute pancreatitis-associated lung injury (APALI). Clinical reports indicated that ~ 20% to 50% of patients from low oxygen levels in blood with acute respiratory distress syndrome (ARDS). ARDS is a severe form of acute lung injury (ALI), a pulmonary disease with impaired airflow making patients difficult to breathe. ALI is frequently observed in patients with severe acute pancreatitis. Approximately one third of severe pancreatitis patients develop acute lung injury and acute respiratory distress syndrome that account for 60% of all deaths within the first week. The major causes of ALI and ARDS are sepsis, trauma, aspiration, multiple blood transfusion, and most importantly acute pancreatitis. The molecular mechanisms of ALI and ARDS are still not well explored, but available reports indicate the involvement of several pro-inflammatory mediators including cytokines (TNF-α, IL-1β, IL-6) and chemokines [like interleukin-8 (IL-8) and macrophage inhibitory factor (MIF)], as well as macrophage polarization regulating the migration and pulmonary infiltration of neutrophils into the pulmonary interstitial tissue, causing injury to the pulmonary parenchyma. Acute lung injury and acute respiratory distress syndrome in acute pancreatitis remains an unsolved issue and needs more research and resources to develop effective treatments and therapies. However, recent efforts have tested several molecules in an experimental model and showed promising results as a treatment option. The current review summarized the mechanism that is operational in pancreatitis-associated acute respiratory failure and respiratory distress syndrome in patients and current treatment options.
{"title":"Chronic Pancreatitis Associated Acute Respiratory Failure.","authors":"Murli Manohar, Alok K Verma, Sathisha Upparahalli Venkateshaiah, Nathan L Sanders, Anil Mishra","doi":"10.15406/moji.2017.05.00149","DOIUrl":"10.15406/moji.2017.05.00149","url":null,"abstract":"<p><p>Pancreatitis is a condition characterized by parenchymal inflammation of the pancreas, which is often associated with lung injury due to low level of oxygen and the condition is termed as acute pancreatitis-associated lung injury (APALI). Clinical reports indicated that ~ 20% to 50% of patients from low oxygen levels in blood with acute respiratory distress syndrome (ARDS). ARDS is a severe form of acute lung injury (ALI), a pulmonary disease with impaired airflow making patients difficult to breathe. ALI is frequently observed in patients with severe acute pancreatitis. Approximately one third of severe pancreatitis patients develop acute lung injury and acute respiratory distress syndrome that account for 60% of all deaths within the first week. The major causes of ALI and ARDS are sepsis, trauma, aspiration, multiple blood transfusion, and most importantly acute pancreatitis. The molecular mechanisms of ALI and ARDS are still not well explored, but available reports indicate the involvement of several pro-inflammatory mediators including cytokines (TNF-α, IL-1β, IL-6) and chemokines [like interleukin-8 (IL-8) and macrophage inhibitory factor (MIF)], as well as macrophage polarization regulating the migration and pulmonary infiltration of neutrophils into the pulmonary interstitial tissue, causing injury to the pulmonary parenchyma. Acute lung injury and acute respiratory distress syndrome in acute pancreatitis remains an unsolved issue and needs more research and resources to develop effective treatments and therapies. However, recent efforts have tested several molecules in an experimental model and showed promising results as a treatment option. The current review summarized the mechanism that is operational in pancreatitis-associated acute respiratory failure and respiratory distress syndrome in patients and current treatment options.</p>","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5793936/pdf/nihms909676.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35793201","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}
Pub Date : 2016-12-30DOI: 10.15406/MOJI.2016.04.00142
M. Sinha, M. Prasad, Rawi Agrawal, Anju Singh, U. Kumar, Amitesh Kumar, R. Kumari, Keshari
Aim: The cerebrospinal fluid concentrations of Lactate dehydrogenase (LDH) were studied in patients with pyogenic, tubercular and viral meningitis in different age and sex group. Material and methods: A total of 160 cases, aged between 1 month and 60 years, including patients with bacterial meningitis (n=50), pyogenic meningitis (n=46), viral meningitis (n=24) and a control group (n=40), were analyzed on the basis of data from the initial clinical examinations. Results:Significant increase in LDH level (P<0.001) were observed in the test group when compared to the control group. Bacterial meningitis is more common than non bacterial meningitis. Pyogenic meningitis is more prevalent under 1 year of age group while tuberculous meningitis is seen most frequently betweens 3 to 5 year of age. Conclusion:The maximum prevalence of different types of meningitis was in the age group of 1 to 10 years age. The LDH level did rise quite significantly in pyogenic meningitis.
{"title":"Clinical Status of Lactate Dehydrogenase Activity in Cerebrospinal Fluid with Age and Sex Distribution in Different Types of Meningitis","authors":"M. Sinha, M. Prasad, Rawi Agrawal, Anju Singh, U. Kumar, Amitesh Kumar, R. Kumari, Keshari","doi":"10.15406/MOJI.2016.04.00142","DOIUrl":"https://doi.org/10.15406/MOJI.2016.04.00142","url":null,"abstract":"Aim: The cerebrospinal fluid concentrations of Lactate dehydrogenase (LDH) were studied in patients with pyogenic, tubercular and viral meningitis in different age and sex group. \u0000 Material and methods: A total of 160 cases, aged between 1 month and 60 years, including patients with bacterial meningitis (n=50), pyogenic meningitis (n=46), viral meningitis (n=24) and a control group (n=40), were analyzed on the basis of data from the initial clinical examinations. \u0000 Results:Significant increase in LDH level (P<0.001) were observed in the test group when compared to the control group. Bacterial meningitis is more common than non bacterial meningitis. Pyogenic meningitis is more prevalent under 1 year of age group while tuberculous meningitis is seen most frequently betweens 3 to 5 year of age. \u0000 Conclusion:The maximum prevalence of different types of meningitis was in the age group of 1 to 10 years age. The LDH level did rise quite significantly in pyogenic meningitis.","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67085224","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 : 2016-12-22DOI: 10.15406/moji.2016.04.00141
Abdulaziz A. Alodhayani, I. Gosadi, M. M. A. Daajani, Salah Ezreqat, H. Mourad, Firas Ghomraoui, Tahani Jathab Alshaibani
King Saud University’s (KSU) medical students are educated on research methodology through a mandatory course. This investigation aims to evaluate these students’ research experience. This is a mixed-methodology study undertaken at the medical college KSU. Four focus groups were performed to allow an in-depth analysis of factors affecting KSU medical students’ research experiences. The qualitative aspect was followed by a quantitative survey to evaluate the KSU medical college faculty’s perception of undergraduate students’ supervisory mission. A total of 49 participants were involved in this study. Thirty-one students participated in the qualitative part. However, only 18 faculty members responded to the online questionnaire (a response rate of 18%). The thematic analysis produced three main themes and 12 subthemes. The main themes were related to organizational factors influencing students’ research experience, how they conducted research and their research outcomes. Quantitative analysis findings indicated that the majority of supervisors think that students’ research weaknesses are related to the development of the research questions, statistical analysis and scientific writing. There is a need to revisit the curriculum structure of KSU medical college and minimize the interference between research and clinical education, and examinations. More emphasis should be given to providing practical training in statistics, scientific writing and supervisory experience enhancement.
{"title":"King Saud University’ Medical Students Research Experience: A Mixed-Methodology Study","authors":"Abdulaziz A. Alodhayani, I. Gosadi, M. M. A. Daajani, Salah Ezreqat, H. Mourad, Firas Ghomraoui, Tahani Jathab Alshaibani","doi":"10.15406/moji.2016.04.00141","DOIUrl":"https://doi.org/10.15406/moji.2016.04.00141","url":null,"abstract":"King Saud University’s (KSU) medical students are educated on research methodology through a mandatory course. This investigation aims to evaluate these students’ research experience. This is a mixed-methodology study undertaken at the medical college KSU. Four focus groups were performed to allow an in-depth analysis of factors affecting KSU medical students’ research experiences. The qualitative aspect was followed by a quantitative survey to evaluate the KSU medical college faculty’s perception of undergraduate students’ supervisory mission. A total of 49 participants were involved in this study. Thirty-one students participated in the qualitative part. However, only 18 faculty members responded to the online questionnaire (a response rate of 18%). The thematic analysis produced three main themes and 12 subthemes. The main themes were related to organizational factors influencing students’ research experience, how they conducted research and their research outcomes. Quantitative analysis findings indicated that the majority of supervisors think that students’ research weaknesses are related to the development of the research questions, statistical analysis and scientific writing. There is a need to revisit the curriculum structure of KSU medical college and minimize the interference between research and clinical education, and examinations. More emphasis should be given to providing practical training in statistics, scientific writing and supervisory experience enhancement.","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":"4 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2016-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67085182","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 : 2016-12-19DOI: 10.15406/moji.2016.04.00140
Dhauna Karam, Peter A Morawiecki, ra S Mouli, B. Agrawal, P. Purohit
Context: Evaluation for Immune thrombocytopenic purpura leading to diagnosis of advanced pancreatic adenocarcinoma has not been previously reported in literature. Case report: We present a case of a 72 year old male who presented to our center with epistaxis, hematuria and prolonged bleeding from leg wound. Complete blood count revealed a platelet count of 2 k/uL. A complete physical exam with an extensive work up, ruled out other causes of thrombocytopenia including drugs, infections, liver disease and coagulation disorders. Computed tomography abdomen and pelvis, done as a part of workup to assess for hepatosplenomegaly revealed a pancreatic and a liver mass. Biopsy of liver mass confirmed the diagnosis of pancreatic adenocarcinoma. A trial of intravenous steroids and immunoglobulins quadrupled the platelet count initially, but then platelet count continued to drop. Further treatment with rituximab improved platelet counts to over 100 k/uL. The absence of any apparent cause of thrombocytopenia, coupled with a response to steroids and immunoglobulins initially, and rituximab later, were confirmatory of immune thrombocytopenia. Conclusion: Immune thrombocytopenic purpura can be the presenting feature of advanced pancreatic adenocarcinoma and our case highlights the importance of a thorough workup that led to diagnosis of pancreatic malignancy. Context: Evaluation for Immune thrombocytopenic purpura leading to diagnosis of advanced pancreatic adenocarcinoma has not been previously reported in literature. Case report: We present a case of a 72 year old male who presented to our center with epistaxis, hematuria and prolonged bleeding from leg wound. Complete blood count revealed a platelet count of 2 k/uL. A complete physical exam with an extensive work up, ruled out other causes of thrombocytopenia including drugs, infections, liver disease and coagulation disorders. Computed tomography abdomen and pelvis, done as a part of workup to assess for hepatosplenomegaly revealed a pancreatic and a liver mass. Biopsy of liver mass confirmed the diagnosis of pancreatic adenocarcinoma. A trial of intravenous steroids and immunoglobulins quadrupled the platelet count initially, but then platelet count continued to drop. Further treatment with rituximab improved platelet counts to over 100 k/uL. The absence of any apparent cause of thrombocytopenia, coupled with a response to steroids and immunoglobulins initially, and rituximab later, were confirmatory of immune thrombocytopenia. Conclusion: Immune thrombocytopenic purpura can be the presenting feature of advanced pancreatic adenocarcinoma and our case highlights the importance of a thorough workup that led to diagnosis of pancreatic malignancy.
{"title":"Immune Thrombocytopenia in Association with Pancreatic Adenocarcinoma","authors":"Dhauna Karam, Peter A Morawiecki, ra S Mouli, B. Agrawal, P. Purohit","doi":"10.15406/moji.2016.04.00140","DOIUrl":"https://doi.org/10.15406/moji.2016.04.00140","url":null,"abstract":"Context: Evaluation for Immune thrombocytopenic purpura leading to diagnosis of advanced pancreatic adenocarcinoma has not been previously reported in literature. \u0000 \u0000 Case report: We present a case of a 72 year old male who presented to our center with epistaxis, hematuria and prolonged bleeding from leg wound. Complete blood count revealed a platelet count of 2 k/uL. A complete physical exam with an extensive work up, ruled out other causes of thrombocytopenia including drugs, infections, liver disease and coagulation disorders. Computed tomography abdomen and pelvis, done as a part of workup to assess for hepatosplenomegaly revealed a pancreatic and a liver mass. Biopsy of liver mass confirmed the diagnosis of pancreatic adenocarcinoma. A trial of intravenous steroids and immunoglobulins quadrupled the platelet count initially, but then platelet count continued to drop. Further treatment with rituximab improved platelet counts to over 100 k/uL. The absence of any apparent cause of thrombocytopenia, coupled with a response to steroids and immunoglobulins initially, and rituximab later, were confirmatory of immune thrombocytopenia. \u0000 \u0000 Conclusion: Immune thrombocytopenic purpura can be the presenting feature of advanced pancreatic adenocarcinoma and our case highlights the importance of a thorough workup that led to diagnosis of pancreatic malignancy. \u0000 \u0000 \u0000 Context: Evaluation for Immune thrombocytopenic purpura leading to diagnosis of advanced pancreatic adenocarcinoma has not been previously reported in literature. \u0000 \u0000 Case report: We present a case of a 72 year old male who presented to our center with epistaxis, hematuria and prolonged bleeding from leg wound. Complete blood count revealed a platelet count of 2 k/uL. A complete physical exam with an extensive work up, ruled out other causes of thrombocytopenia including drugs, infections, liver disease and coagulation disorders. Computed tomography abdomen and pelvis, done as a part of workup to assess for hepatosplenomegaly revealed a pancreatic and a liver mass. Biopsy of liver mass confirmed the diagnosis of pancreatic adenocarcinoma. A trial of intravenous steroids and immunoglobulins quadrupled the platelet count initially, but then platelet count continued to drop. Further treatment with rituximab improved platelet counts to over 100 k/uL. The absence of any apparent cause of thrombocytopenia, coupled with a response to steroids and immunoglobulins initially, and rituximab later, were confirmatory of immune thrombocytopenia. \u0000 \u0000 Conclusion: Immune thrombocytopenic purpura can be the presenting feature of advanced pancreatic adenocarcinoma and our case highlights the importance of a thorough workup that led to diagnosis of pancreatic malignancy.","PeriodicalId":90928,"journal":{"name":"MOJ immunology","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67085171","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}
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：