1/35. association of reticular dysgenesis (thymic alymphoplasia and congenital aleukocytosis) with bilateral sensorineural deafness.Reticular dysgenesis is a rare congenital disorder characterized by severe combined immunodeficiency and profound neutropenia, curable to date, only by bone marrow transplantation. This report describes the association of bilateral sensorineural deafness with this disease.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
2/35. Monocyte deactivation and its reversal in a patient with chemotherapy-induced leukopenia and severe systemic infection.BACKGROUND: Serious infections constitute a major problem for patients with cancer, and new approaches must be found in dealing with these. The pathophysiology of neutropenic infection is not well understood, although there is some evidence that, as in sepsis in the primarily immunocompetent host, a pro- and an antiinflammatory phase can be discriminated. In the recent literature is described a series of nonneutropenic patients with sepsis in whom interferon-gamma was successfully administered during the immunoparalytic phase, a concept that might possibly be extended to immunocompromised hosts. PROCEDURE: A 14-year-old patient with RAEB-T/hypoplastic M2 and chemothera py-induced neutropenia developed a severe infection and continued to deteriorate clinically despite maximum supportive measures, including broad antibacterial and antifungal coverage. On the basis of monocyte de-activation this patient was considered to be in the immunoparalytic phase of sepsis and consequently treated with 60 microg/m(2) of interferon-gamma per day for 10 days. RESULTS: The patient made a rapid clinical recovery, and biochemical markers of infection improved promptly. At the same time, the fraction of activated monocytes normalized rapidly and stably. We hypothesize that treatment with interferon-gamma effected this rapid restoral of monocyte activation and that monocyte reactivation might have contributed to the patient's prompt recovery from his severe infection. interferon-gamma treatment was well tolerated. CONCLUSIONS: Immunostimulation with interferon-gamma might prove to be a valuable adjuvant treatment for patients with chemotherapy-induced neutropenia during the rare scenario of infection with immunoparalysis.- - - - - - - - - - ranking = 2keywords = neutropenia (Clic here for more details about this article) |
3/35. zinc-induced anemia and neutropenia in an adolescent.We report an adolescent who developed anemia, leukopenia, and neutropenia after prolonged use of over-the-counter zinc for treatment of acne. Hypocupremia and sideroblastic anemia may result from long-term or excessive exposure to zinc.- - - - - - - - - - ranking = 5keywords = neutropenia (Clic here for more details about this article) |
4/35. parvovirus B19 causing leucopenia and neutropenia in a healthy adult.A 27-year-old healthy female presented with a prolonged and intermittent febrile illness. She was found to have leucopenia, neutropenia and thrombocytopenia, but a normal haemoglobin. The patient recovered spontaneously and convalescent serology 1 month later was positive for specific parvovirus B19 IgM and IgG. parvovirus B19 infection was confirmed by detection of viral dna by dot blot hybridization in a specimen of blood taken during the acute illness. A review of the previously reported cases of parvovirus B19-induced leucopenia in normal adults is presented. parvovirus B19 should be considered in the differential diagnosis of leucopenia and neutropenia in healthy adults.- - - - - - - - - - ranking = 6keywords = neutropenia (Clic here for more details about this article) |
5/35. Olanzapine appears haematologically safe in patients who developed blood dyscrasia on clozapine and risperidone.We report a 2-year experience with olanzapine treatment (20 mg daily) in a 65-year-old male patient with treatment-resistant paranoid schizophrenia, who had previously developed leucopenia and neutropenia first on clozapine and, subsequently, also on risperidone. Olanzapine seems to be safe in this patient, since no major decreases of haematological parameters were observed. The only exception was a brief decrease of leucocyte and neutrophil (but not erythrocyte or platelet) counts during influenza-like viral infection. However, the control of psychotic symptoms on olanzapine is not as good as on clozapine.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
6/35. Olanzapine-induced leukopenia with human leukocyte antigen profiling.Olanzapine is an atypical antipsychotic medication frequently used in the management of psychotic states. While it has proved to be safe compared to clozapine with regard to haematotoxicity, because it has only been available for a few years, full documentation of its haematological side-effects remains incomplete. We report a case of olanzapine-induced leukopenia with associated neutropenia. Since clozapine-induced haematotoxicity has been associated with characteristic human leukocyte antigen (HLA) groups, HLA typing was determined in this patient. Following failure with typical antipsychotic medication, the patient received 10 mg/day of olanzapine. Three weeks later, he developed fever and a significant decrease in leukocyte count. Olanzapine was immediately discontinued. HLA typing was determined. The white cell count returned to normal and the fever, most probably secondary to the low white cell count, subsided with antibiotic treatment. HLA typing results were: A1 24, B7, B35, DRB1*15, DRB1*11, DRB3*01-03, DRB5*01-02. Olanzapine may induce serious leukopenia and neutropenia. HLA typing in this single patient demonstrated a distinct haplotype compared to that previously observed in clozapine-induced haematoxicity.- - - - - - - - - - ranking = 2keywords = neutropenia (Clic here for more details about this article) |
7/35. Excessive oral zinc supplementation.The use of megadoses of vitamin and mineral supplements has become common. The authors describe a 17-year-old boy who presented with fatigue after taking large daily doses of zinc supplements for 6 to 7 months in an attempt to treat his acne. A zinc-induced hypocupremia developed, causing anemia, leukopenia, and neutropenia. anemia and neutropenia resolved 6 months after he stopped taking the zinc. Excessive zinc intake can have toxic effects, and questions about patients' use of vitamin and mineral supplements should be asked when medication histories are taken.- - - - - - - - - - ranking = 2keywords = neutropenia (Clic here for more details about this article) |
8/35. Complete remission of pure white cell aplasia associated with thymoma, autoimmune thyroiditis and type 1 diabetes.Pure white cell aplasia (PWCA) is a rare disorder of unknown origin, often associated with thymoma, characterized by selective neutropenia or pure agranulocytosis, and absence of granulocyte precursors in the bone marrow, but with normal erythroblasts and megakaryocytes. We report a case of PWCA associated with thymoma. Unusual findings in this case report included simultaneous presence of autoimmune thyroiditis, type 1 diabetes, anti-striated muscle antibodies, and the presence in the peripheral blood of CD8 T cells that expressed a homogeneous naive phenotype. Neutrophil count became normal on immunosuppressive therapy after thymectomy.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
9/35. Investigation into the usefulness and adverse events of CDDP, 5-fU and dl-leucovorin (PFL-therapy) for advanced colorectal cancer.Biochemical modulation of 5-fluorouracil (5-FU) has been verified the evidence of significant improvement of survival and quality of life in patients with advanced colorectal carcinoma. We investigated the therapeutic and adverse drug reaction of intensive chemotherapy using cisplatin (CDDP), 5-FU and dl-leucovorin (LV) (PFL-therapy), which may be producing dual biochemical modulation effect of 5-FU for advanced colorectal carcinoma. Administration schedule was 13 mg/m2 of CDDP, 300 mg/m2 of 5-FU, and 30 mg/body of dl-LV for 5 consecutive days. This regimen was repeated at 3-week intervals in hospital. Sixteen patients were enrolled in this study, most of whom had a history of previous chemotherapy as adjuvant treatment, and the response rate was 25%, with four patients having "partial response" and eight "no change". In respect to performance status, 46% of patients who completed the protocol were markedly improved in spite of their poor performance status before treatment. Moreover, when patients were classified into two groups based on changes of the serum level of CEA, "responder in CEA level" showed better prognosis than "non-responder in CEA level". Major toxicities were nausea, hyperglycemia and neutropenia. Three patients experienced Grade 4 hematological side effect, but these complications resolved quickly in all patients except for one patient. PFL-therapy is effective for advanced colorectal cancer with large tumor burden and showed the same prognostic result as the American and European trials in spite of smaller number of treatment cycles and a history of previous chemotherapy. We will be able to demonstrate the usefulness of this regimen for Japanese patients with advanced colorectal cancers after adding new cases to the present report.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
10/35. Transient fetal myelosuppressive effect of D-penicillamine when used in pregnancy.Normal fertility is sustained by progress in the medical therapy of Wilson's disease; however, pregnancy complications are encountered more frequently. The mother we present is a Wilson's disease patient who had been compliant with D-penicillamine for the preceding 13 years. She was admitted with unplanned pregnancy at the 16th gestational week. The dose of D-penicillamine could be reduced to 600 mg/d related to the underlying disease. Pregnancy ended with premature labor and delivery at the 29-30th weeks. The baby experienced type I respiratory distress and was treated by surfactant and mechanical ventilation. neutropenia and leucopenia were documented at 6th postnatal hours. The baby showed neutropenia and leucopenia for 5 days and resolving without any further therapy. Intrauterine D-penicillamine was suspected to cause transient neonatal myelosuppression.- - - - - - - - - - ranking = 1keywords = neutropenia (Clic here for more details about this article) |
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