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Revista Da Sociedade Brasileira de... Apr 2016Vancomycin is the first-line agent for the treatment of bacteremia, endocarditis, pneumonia, cellulitis, and osteomyelitis. Pancytopenia is an uncommon adverse effect of...
Vancomycin is the first-line agent for the treatment of bacteremia, endocarditis, pneumonia, cellulitis, and osteomyelitis. Pancytopenia is an uncommon adverse effect of vancomycin therapy, with only a few cases of vancomycin-related neutropenia and pancytopenia described in the literature. We describe a case of a 56-year-old man who was diagnosed with chronic paraspinal abscess and started on intravenous vancomycin. He was re-admitted two weeks later with new-onset pancytopenia. Discontinuation of vancomycin resulted in improved cell counts. Physicians should monitor cell counts in patients who are on long-term intravenous vancomycin.
Topics: Abscess; Anti-Bacterial Agents; Humans; Male; Middle Aged; Pancytopenia; Spinal Diseases; Vancomycin
PubMed: 27192600
DOI: 10.1590/0037-8682-0263-2015 -
British Journal of Haematology Jul 2019
Topics: Adult; Bone Marrow Cells; Female; Humans; Megakaryocytes; Pancytopenia; Thrombopoiesis; Valproic Acid
PubMed: 31119727
DOI: 10.1111/bjh.15974 -
American Journal of Hematology Apr 2008The aim of the study is to review the clinical manifestations and the hematological findings of brucellosis and pancytopenia, with or without hematological malignancies....
A multicenter retrospective study defining the clinical and hematological manifestations of brucellosis and pancytopenia in a large series: Hematological malignancies, the unusual cause of pancytopenia in patients with brucellosis.
The aim of the study is to review the clinical manifestations and the hematological findings of brucellosis and pancytopenia, with or without hematological malignancies. The records of 202 patients with brucellosis were evaluated retrospectively. Among these cases of brucellosis seen in a 6 year period between April 1999 and June 2005, 30 patients with pancytopenia were identified. The most common manifestation was fever, followed by weight loss, anorexia, malaise, arthralgia, and hepatosplenomegaly. Bone marrow biopsies revealed hypercellularity or normocellularity. The most common findings in the bone marrow evaluation were histiocytic hemophagocytosis and granulomas. Among all cases, we diagnosed 5 hematological malignancies (1 acute myelogenous leukemia, 2 acute lymphoblastic leukemia, and 2 multiple myeloma) concurrently with brucellosis. The clinical symptoms and findings were similar in patients with and without malignancies. In cases with malignancies, the bone marrow biopsy revealed predominant primary disease involvement. Significant increases in ESR and CRP, severe anemia and thrombocytopenia were observed in patients with malignancies. Peripheral blood counts in patients without malignancies returned to normal after antibiotic treatment for brucellosis. However, pancytopenia in two patients with malignancies did not recover because of primary resistant disease. We conclude that while histiocytic hemophagocytosis may be considered as a major cause of pancytopenia, leukemic infiltration can also be an extreme and unusual cause of pancytopenia in patients in whom brucellosis was concurrently diagnosed with hematological malignancies.
Topics: Adolescent; Adult; Aged; Agglutination Tests; Bone Marrow; Brucellosis; Comorbidity; Female; Hematologic Neoplasms; Humans; Leukemia, Myelomonocytic, Acute; Leukemic Infiltration; Lymphohistiocytosis, Hemophagocytic; Male; Middle Aged; Multiple Myeloma; Pancytopenia; Precursor Cell Lymphoblastic Leukemia-Lymphoma; Retrospective Studies; Risk Factors; Treatment Outcome
PubMed: 18069671
DOI: 10.1002/ajh.21098 -
BMC Geriatrics Mar 2021Pancytopenia, fever, and elevated D-dimer are significant clinical findings. The differential diagnosis includes hematological malignancies, severe coronavirus disease...
BACKGROUND
Pancytopenia, fever, and elevated D-dimer are significant clinical findings. The differential diagnosis includes hematological malignancies, severe coronavirus disease 2019 (COVID-19), tick-borne illnesses, and other etiologies.
CASE PRESENTATION
We report the case of a 95-year-old woman who presented with high fever (103.6 °F), pancytopenia, and markedly elevated D-dimer (32.21 mg/L; reference range ≤ 0.95 mg/L) in late-autumn during the COVID-19 pandemic at a large academic institution. After remaining persistently febrile, a peripheral blood smear was ordered and revealed parasites consistent with Ehrlichia spp. Doxycycline monotherapy led to symptomatic improvement and resolution of her pancytopenia. During her hospital stay, a computed tomography angiogram of the chest revealed pulmonary emboli, and esophagogastroduodenoscopy uncovered arteriovenous malformations. After appropriate treatment, she was discharged on hospital day 7 and has since done well.
CONCLUSIONS
Overall, our case offers a dramatic, unexpected presentation of ehrlichiosis in a nonagenarian. To our knowledge, this is the first report of concurrent ehrlichiosis and pulmonary embolus.
Topics: Aged, 80 and over; COVID-19; Ehrlichiosis; Female; Fibrin Fibrinogen Degradation Products; Humans; Pancytopenia; Pandemics; SARS-CoV-2
PubMed: 33711942
DOI: 10.1186/s12877-021-02129-6 -
Eating and Weight Disorders : EWD Dec 2022A 15-year-old female patient with anorexia nervosa presented an unusually prolonged and severe episode of pancytopenia with severe thrombopenia and severe leucopenia....
A 15-year-old female patient with anorexia nervosa presented an unusually prolonged and severe episode of pancytopenia with severe thrombopenia and severe leucopenia. Despite effective refeeding, active specialized interventions were necessary. Upon admission, the patient presented with severe and symptomatic thrombopenia, severe neutropenia and gelatinous marrow transformation. In addition to refeeding, active interventions such as platelet transfusion and granulocyte-colony stimulating factor were successful to manage the patient's complications. The etiological search for pancytopenia was negative. The patient's prolonged starvation was probably a key factor. Medical history, clinical presentation, evolution, and biological data including bone marrow aspiration results are presented. Management of cytopenia and of their complications in a context of severe starvation is discussed in regard of existing literature. A simple monitoring attitude may prove insufficient in cases of severe pancytopenia in anorexia nervosa.Level of evidence V, descriptive study.
Topics: Female; Humans; Adolescent; Pancytopenia; Anorexia Nervosa; Bone Marrow; Neutropenia; Thrombocytopenia
PubMed: 36131194
DOI: 10.1007/s40519-022-01478-4 -
Archivos Argentinos de Pediatria Aug 2016Azathioprine is an immunosuppressive drug that has shown effectiveness in inflammatory bowel disease treatment. Its metabolite, 6-mercaptopurine, is metabolized through...
Azathioprine is an immunosuppressive drug that has shown effectiveness in inflammatory bowel disease treatment. Its metabolite, 6-mercaptopurine, is metabolized through thiopurine methyltransferase. Patients with low enzyme activity may have more frequent and severe side effects. The most common is leukopenia, and rarely pancytopenia. The thiopurine methyltransferase activity monitoring shows an individualized profile of enzymatic activity but it should not replace monitoring by performing serial blood counts. In patients with fever and severe neutropenia, early empirical antibiotic treatment should be initiated to prevent severe and disseminated infection. Two patients with this condition are reported.
Topics: Adolescent; Azathioprine; Female; Humans; Immunosuppressive Agents; Pancytopenia
PubMed: 27399027
DOI: 10.5546/aap.2016.e252 -
Journal of Veterinary Internal Medicine Jan 2023In spring 2021 increasing numbers of cats presenting with severe pancytopenia were noted in United Kingdom (UK).
BACKGROUND
In spring 2021 increasing numbers of cats presenting with severe pancytopenia were noted in United Kingdom (UK).
OBJECTIVE
To describe process and outcome of the investigation performed into the outbreak of pancytopenia in cats.
ANIMALS
Five hundred and eighty client owned cats that presented with severe bi- or pancytopenia of unknown cause.
METHODS
Real-time data collection was performed by an online registration forum available to all veterinary surgeons in UK. Data collected included demographics, clinicopathological findings, diagnostic testing, dietary and drug history, outcome and COVID household status. Mycotoxicological feed analysis was performed on feed samples of 3 diets frequently mentioned in the database and 3 control diets.
RESULTS
Five hundred and eighty cats presented to 378 veterinary practices were included for analysis. Case fatality rate was 63.3%. Dietary history was available for 544 (93.8%) cats, of which 500 (86%) were fed 1 of 3 diets (which were recalled midinvestigation). 54 (9.3%) cats were not fed a recalled product, with diet information unknown in 26 (4.5%) cats. Analysis of feed samples revealed concentrations of hematotoxic trichothecene T-2/HT-2 mycotoxins greater than recommended by the European Commission in 5/7 recalled diet samples but in none of control diet samples. The trichothecene mycotoxin diacetoxyscirpenol (DAS) was detectable in all recalled diet samples but not in any of control samples.
CONCLUSION AND CLINICAL IMPORTANCE
Contaminated-feed induced trichothecene mycotoxicosis should be considered as a differential diagnosis for pancytopenia in cats.
Topics: Animals; Cats; Pancytopenia; Food Contamination; COVID-19; Trichothecenes; Mycotoxins; Diet; United Kingdom; Disease Outbreaks; Animal Feed; Cat Diseases
PubMed: 36610017
DOI: 10.1111/jvim.16615 -
Analytical Cellular Pathology... 2022Lymphocyte activation gene 3 (LAG3) is an inhibitory checkpoint protein expressed on activated T effector, T regulatory, and natural killer cells. The main function of...
INTRODUCTION
Lymphocyte activation gene 3 (LAG3) is an inhibitory checkpoint protein expressed on activated T effector, T regulatory, and natural killer cells. The main function of LAG3 is the regulation of immune homeostasis. Several studies have suggested its role in malignant and autoimmune diseases. The objective of this study was to explore the association between single-nucleotide polymorphisms (SNPs) and bone marrow failure diseases.
METHODS
Sixty-two patients newly diagnosed with bone marrow failure diseases in the Hematology Department of Tianjin Medical University General Hospital between January 2019 and December 2020 and 16 healthy controls were enrolled in this study. SNPs in were investigated by performing Sanger sequencing, and the association of the detected SNPs with bone marrow failure diseases was analyzed.
RESULTS
Eleven SNPs were identified. Among them, the frequency of LAG3 rs1941928301 (C>T) was statistically different among the groups ( = 0.013). It was higher in the myelodysplastic syndrome (MDS) group than that in the severe aplastic anemia (SAA) group ( = 0.004) and that in the healthy control group ( = 0.009).
CONCLUSIONS
LAG3 rs1941928301 (C>T) might be associated with a higher risk of MDS. The detected SNPs have no apparent effect on susceptibility to SAA and immune-related pancytopenia (IRP).
Topics: Antigens, CD; Bone Marrow Failure Disorders; Humans; Pancytopenia; Polymorphism, Single Nucleotide; Lymphocyte Activation Gene 3 Protein
PubMed: 35265454
DOI: 10.1155/2022/3528598 -
Journal of Infection in Developing... Nov 2023Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hematologic disease segregated into familial (primary) and acquired (secondary) subtypes....
INTRODUCTION
Hemophagocytic lymphohistiocytosis (HLH) is a rare and life-threatening hematologic disease segregated into familial (primary) and acquired (secondary) subtypes. Hyperinflammation and HLH occur when the immune system fails to clear activated macrophages and histiocytes. Infections, malignancies, and rheumatologic disorders are the major triggers leading to HLH. Miliary tuberculosis is a serious disease with a lymphohematogenous spread of Mycobacterium tuberculosis, which is known to be one of the causative agents of HLH. Miliary tuberculosis and HLH have atypical presentations which are similar to routine diseases. Hence, physicians may face challenges to diagnose and treat these complications.
CASE REPORT
We report the case of a 60-year-old man with a history of prolonged fever, shortness of breath, jaundice, altered mental status, undiagnosed lower back pain, and overuse of parenteral betamethasone. Miliary tuberculosis was diagnosed by diffuse, vague random micronodules in both lungs and positive acid-fast bacilli in bronchoalveolar lavage and bone marrow aspiration and biopsy. Moreover, compatible presentation and pancytopenia, hypertriglyceridemia, high serum level of ferritin and fibrinogen-derived products, and evidence of hemophagocytosis on bone marrow aspirate led to the diagnosis of HLH. Unfortunately, despite nearly two months of an anti-tuberculosis regimen (standard and salvage) and eight doses of etoposide, he eventually passed away after clinical improvement.
CONCLUSIONS
Irrational and indiscriminate use of glucocorticoids can be a devastating cause of the spread of tuberculosis and its rare complications, such as HLH.
Topics: Male; Humans; Middle Aged; Lymphohistiocytosis, Hemophagocytic; Tuberculosis, Miliary; Pancytopenia; Etoposide; Adrenal Cortex Hormones
PubMed: 38064397
DOI: 10.3855/jidc.17303 -
International Journal of Environmental... Dec 2015Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at...
Pancytopenia is seen in late HIV infection; it is associated with medical complications and with decreased survival. We determined the prevalence of pancytopenia at baseline in a cohort of HIV-positive Hispanics living in Puerto Rico, and compared their socio-demographic, immunological and clinical characteristics. A total of 1202 patients enrolled between 2000 and 2010 were included. They were grouped according to pancytopenia status, defined by having: platelets <150,000 μL, white cell count <4000 μL, and hemoglobin <12 g/dL (women) or <13 g/dL (men). Differences were evaluated using Student's t-test, Chi-square test and Kaplan-Meier method. The prevalence of pancytopenia was 8.7%. Patients with pancytopenia had lower BMI and lower CD4 count, as well as higher HIV viral load and higher proportions of unemployment, clinical AIDS and antiretroviral treatment (ART) use (p < 0.05). One-year mortality rate was significantly higher in patients with pancytopenia (18.1% vs. 5.1%, p < 0.001). When stratifying for ART this association persisted for patients who did not receive ART (41.4% vs. 5.2%, p < 0.001), but it was not seen in patients who received treatment (9.2% vs. 5.6%, p = 0.196). Pancytopenia was associated with elements of advanced stages of HIV. ART could reduce the mortality of HIV-patients with pancytopenia to levels comparable to patients without the disorders.
Topics: Acquired Immunodeficiency Syndrome; Adult; Aged; Anti-HIV Agents; CD4 Lymphocyte Count; Female; HIV Infections; Hispanic or Latino; Humans; Longitudinal Studies; Male; Middle Aged; Pancytopenia; Prevalence; Puerto Rico; Viral Load
PubMed: 26703689
DOI: 10.3390/ijerph13010038