1/98. Fatal neutropenia and thrombocytopenia associated with ticlopidine after stenting.We report 3 cases of fatal neutropenia and thrombocytopenia associated with ticlopidine after coronary stenting. patients should be counseled about the early signs of infection and bleeding and to have regularly scheduled complete blood counts.- - - - - - - - - - ranking = 1keywords = thrombocytopenia (Clic here for more details about this article) |
2/98. Rapid development of severe copper deficiency in a patient with Crohn's disease receiving parenteral nutrition.A 32-year-old man with active Crohn's disease and recurrent small bowel strictures underwent abdominal surgery and was subsequently given total parenteral nutrition (TPN). Severe cholestasis developed and copper was removed from the TPN. Although serum ceruloplasmin levels were within normal limits, 8 weeks after copper removal, he developed pancytopenia. serum copper levels were severely depressed. bone marrow biopsy was consistent with copper deficiency; cytoplasmic vacuolization of both myeloid and erythroid precursors, megaloblastic erthropoiesis, and marked hypocellularity were observed. IV replacement with copper sulfate resulted in improvement in the patient's anemia, neutropenia, and thrombocytopenia, but the patient died suddenly from cardiac tamponade. Postmortem examination revealed fibrinous and hemorrhagic pericarditis. Despite the rare occurrence of overt copper deficiency, this case emphasizes the need to recognize copper deficiency as an important etiology of iron-resistant anemia in patients receiving TPN. Furthermore, the relative rapidity with which our patient developed pancytopenia suggests that, in view of the established recommendation that copper be removed from TPN in cholestatic conditions, serum copper levels must be measured periodically.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
3/98. Alloimmune neonatal neutropenia treated with rHuG-CSF.Infants with alloimmune neonatal neutropenia (ANN) may be at risk of life-threatening infection. Various modalities of treatment have been attempted but with differing results. We describe a case treated with rHuG-CSF. The use of rHuG-CSF should be considered in children with ANN especially when associated with life-threatening infection.- - - - - - - - - - ranking = 6.3538516776873keywords = alloimmune (Clic here for more details about this article) |
4/98. Two cases of olanzapine-induced reversible neutropenia.Olanzapine is a tricyclic neuroleptic agent that due to structural similarities was expected to be a safe alternative to clozapine, which has a 0.5-2% risk of agranulocytosis. So far, only rare cases of leukocytopenia and thrombocytopenia have become known. In the association, "Drug safety in psychiatry", which is made up of 25 German psychiatric hospitals, two cases of olanzapine-induced neutropenia occurred in patients with chronic schizophrenia. The adverse drug reaction was noticed 17 days after the first intake of olanzapine in case 1 and more than 5 months after the first intake in case 2. In the second case, a reexposure to olanzapine caused the neutrophil cells to decrease again. There were no clinical signs of an infection, and the blood cell counts increased immediately to normal ranges after discontinuation of olanzapine. No special treatment was necessary.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
5/98. Treatment of severe neutropenia due to Felty's syndrome or systemic lupus erythematosus with granulocyte colony-stimulating factor.OBJECTIVES: To examine the efficacy and safety of recombinant human granulocyte colony-stimulating factor (rhG-CSF) and recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) for the treatment of severe neutropenia due to Felty's syndrome (FS) or systemic lupus erythematosus (SLE). methods: Eight patients with absolute neutrophil counts (ANC) below 1,000/microL attributable to FS (n = 4) or SLE (n = 4) were treated with rhG-CSF. The hematologic and clinical response as well as side effects were recorded. In addition, reports on the use of rhG-CSF/rhGM-CSF in FS and SLE retrieved from the English language literature were analyzed. RESULTS: RhG-CSF effectively corrected neutropenia due to FS and SLE in seven of the current eight patients. In 54 of 55 FS and SLE patients retrieved from the literature, G-CSF or GM-CSF, respectively, proved to be effective at elevating the neutrophil count, which was often associated with improvement of infectious complications. The neutrophil count often declined again when growth factor treatment was stopped but generally stabilized at a level that exceeded the pretreatment count. Side effects included rare cases of thrombocytopenia, arthralgias, and development of cutaneous leukocytoclastic vasculitis. Side effects were dose dependent and resolved when treatment was discontinued. One of our own patients and 17 previously reported patients continued to benefit from long-term administration of rhG-CSF over periods of more than 40 months. CONCLUSIONS: RhG-CSF is an effective and generally well-tolerated treatment for neutropenia due to FS or SLE. Exacerbation of the underlying rheumatic condition due to G-CSF appears to be rare if G-CSF is administered at the lowest dose effective at elevating the ANC above 1,000/microL.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
6/98. Neutrophil antigen 5b is carried by a protein, migrating from 70 to 95 kDa, and may be involved in neonatal alloimmune neutropenia.BACKGROUND: Neutrophil antigen 5b has been described as involved in transfusion reactions and not in neonatal alloimmune neutropenia. CASE REPORT: Anti-5b was found in the serum of a mother of a persistently neutropenic newborn, who had several bacterial infections. The neutropenia responded to treatment with recombinant human granulocyte-colony-stimulating factor. immunoprecipitation experiments performed with this and three other 5b antisera identified a protein, migrating from 70 to 95 kDa, as carrier of 5b. The observed pattern of migration may point to heavy glycosylation of this protein. RESULTS: Six 5b-negative donors were identified among 54 screened white donors, for a 5b gene frequency of 0.66. CONCLUSION: Alloimmunization to 5b in pregnancy is rare. In the patients with neonatal neutropenia analyzed in the last decade, this was the first case discovered.- - - - - - - - - - ranking = 71.868626899186keywords = neonatal alloimmune, alloimmune (Clic here for more details about this article) |
7/98. 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 = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
8/98. neutropenia and anaemia due to carbimazole-dependent antibodies.carbimazole-dependent antibodies to erythrocytes were detected in the sera of three anaemic patients who had been treated with carbimazole for hyperthyroidism. By the use of Rhnull-typed erythrocytes, we could show that some of these were directed against the proteins of the Rh complex. carbimazole-dependent antibodies eluted from erythrocytes showed no binding to other blood cells. One patient also presented with neutropenia and mild thrombocytopenia. Additional carbimazole-dependent antibodies against the neutrophil-specific Fcgamma receptor IIIb (FcgammaRIIIb, CD16b) and the broadly expressed platelet endothelial cell adhesion molecule 1 (PECAM-1; CD31) were detected in this patient's serum. Surprisingly, the PECAM-1-reactive drug-dependent antibodies were also detectable in the sera of the other two patients with normal leucocyte and platelet counts. We assume that carbimazole can induce cell lineage-specific drug-dependent antibodies that cause cytopenia and also drug-dependent antibodies against the broadly expressed PECAM-1 molecule that may cause mild but not severe cytopenia.- - - - - - - - - - ranking = 0.2keywords = thrombocytopenia (Clic here for more details about this article) |
9/98. Zuclopenthixol-associated neutropenia and thrombocytopenia.OBJECTIVE: To report a case of neutropenia and thrombocytopenia secondary to use of zuclopenthixol in a schizophrenic patient. CASE SUMMARY: A 66-year-old white man with chronic schizophrenia was referred to the hospital due to neutropenia and thrombocytopenia that developed shortly after initiation of zuclopenthixol therapy. Prior to zuclopenthixol administration, his white blood cell and platelet counts were 8.5 x 10(9) cells/L3 and 305 cells x 10(9)/L, respectively. Progressive reduction in leukocyte and platelet counts occurred, reaching a nadir of 2.9 x 10(9) cells/L3 (granulocytes 18.9%) and 109 cells x 10(9)/L, respectively. Zuclopenthixol was discontinued on admission, resulting in complete recovery within the next five days. DISCUSSION: neutropenia and thrombocytopenia are well-known complications of antipsychotic drug therapy. Zuclopenthixol, a well-established antipsychotic agent, has relatively few adverse effects. The rapid decrease of white blood cell and platelet counts following the initiation of zuclopenthixol, as well as the rapid recovery, implicate zuclopenthixol as the predominant cause for neutropenia and thrombocytopenia in this patient. CONCLUSIONS: Although neutropenia and thrombocytopenia are rare complications of zuclopenthixol therapy, monitoring blood counts in patients receiving this agent seems to be justified.- - - - - - - - - - ranking = 1.8keywords = thrombocytopenia (Clic here for more details about this article) |
10/98. Neonatal alloimmune neutropenia in premature monozygous twins.Alloimmune neonatal neutropenia (ANN) is an uncommon but potentially life-threatening disorder of the neonate and young infant. Hematologically, the mother's peripheral neutrophil count is normal. However, the passive transfer of maternal immunoglobulin g neutrophil-specific antibodies and the subsequent sensitization of fetal neutrophils can result in severe neutropenia in the neonate. Generally, ANN is a self-limiting condition, but with severe bacterial infection, mortality can be high. We present the clinical features of monozygous twins delivered at 33 weeks' postconception with this condition. This case report is unique in that it occurred in twins born prematurely and was attributable to antibodies against 2 neutrophil-specific antigens, NA1 and NB1. A brief review of the diagnosis, management, and treatment of ANN is presented.- - - - - - - - - - ranking = 25.415406710749keywords = alloimmune (Clic here for more details about this article) |
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