Cases reported "Anemia, Hypochromic"

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1/19. chloramphenicol-a possible role in the treatment of leukaemia?

    The effect of chloramphenicol in short term in-vitro bone marrow cultures was studied. There was a striking reduction in the incorporation of tritiated thymidine into dna in bone marrow cultures with abnormal proliferative properties as compared with normal tissue. A 50% reduction in dna thymidine incorporation in leukaemia marrow was also obtained with in-vitro chloramphenicol concentrations which in contrast had little or no effect in normal tissue. These in-vitro levels of the antibiotic can be readily achieved in vivo. An in-vivo study confirmed the ability of chloramphenicol to reduce the white cell and blast count in a patient with chronic myeloid leukaemia in blastic transformation.
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keywords = bone
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2/19. A case of hemorrhagic cyst of the pancreas resembling the cystic endometriosis.

    A 47-year-old Japanese woman with a history of epigastric pain and a recent episode of acute pancreatitis (back pain, nausea, and vomiting) and anemia was found to have a pancreatic cyst of the tail on CT-scan and ultrasonography. Especially, ultrasonography revealed the papillary solid lesion in the cyst. With the tentative diagnosis of a cystic neoplasm, distal pancreatectomy was performed. Histological examination of sections showed massive hemorrhage, surrounded fibrous connective tissue, and numerous macrophages with hemosiderin deposits; these histological findings resembled cystic endometriosis. The clinicopathological features and pathogenesis of the pancreatic endometrial cyst are discussed.
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ranking = 238.68195013285
keywords = macrophage
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3/19. Soft-tissue concentration of 99mTc-phosphates associated with injections of iron dextran complex.

    An unusual concentration of 99mTc-phosphates appeared in the gluteal area in bone scans of three patients who had recently had intramuscular injections of iron dextran complex. These cases indicate one more cause for extraosseous accumulation of these bone-seeking radiopharmaceuticals.
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keywords = bone
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4/19. Congenital sideroblastic anemia without clinical iron overload. A case report.

    An 18 year old boy presented with microcytic hypochromic anemia. Erythrocytic abnormalities and family studies suggested congenital sideroblastic anemia (CSA), but atypical features included absence of clinical iron overload, scanty iron deposits in mitochondria of late erythroblasts and reticulocytes, and a high platelet count. An unusual adhesion between bone marrow macrophages and reticulocytes was observed by electron microscopy. Haematological response was seen following pyridoxine administration, thus fending support to the diagnosis of CSA.
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ranking = 239.18195013285
keywords = macrophage, bone
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5/19. pica as a presenting symptom in childhood celiac disease.

    Persistent pica may be either a cause or a result of iron deficiency. Three children are described with long-standing pica and iron-deficiency anemia and in whom total villous atrophy consistent with celiac disease was found on jejunal biopsy. Additional findings included short stature, delayed bone age, and impaired xylose absorption. A dramatic growth spurt and complete resolution of pica were observed after a gluten-free diet. In these cases pica evidently resulted from iron deficiency secondary to malabsorption. Underlying celiac disease should be considered in children with persistent pica and growth failure even if gastrointestinal disturbances are minimal.
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keywords = bone
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6/19. case management of the anemic patient. Epoetin alfa: focus on kinetic dosing.

    Epoetin alfa (EPOGEN, recombinant human erythropoietin) has proven to be a major therapeutic advance in treating the chronic refractory anemia associated with end-stage renal disease (ESRD). As with many medications, the dose of Epoetin alfa must be individualized for each patient. In order to elicit a consistent production of red cells from the bone marrow, it is desirable that dose modifications be made as infrequently as possible. Gotch and Uehlinger have developed a kinetic model that can limit dose modifications by predicting the optimal dose of Epoetin alfa for each patient. Termed the Erythrokinetic Model, it compares individual patient response to Epoetin alfa to the life cycle of a red blood cell. This article describes the Gotch/Uehlinger Erythrokinetic Model and uses it to gauge the clinical response of 2 patients to Epoetin alfa.
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7/19. heme metabolism and in vitro erythropoiesis in anemia associated with hypochromic microcytosis.

    heme metabolism and in vitro erythropoietic growth (CFU-E, BFU-E) were examined in bone marrow cells taken from two siblings with apparent familial hypochromic microcytic anemia. bone marrow cells from both patients grew adequate numbers of CFU-E and BFU-E colonies in culture in the presence of erythropoietin. In addition, small numbers of endogenous CFU-E were seen in 7-day cultures. Assays on bone marrow cells taken from both patients revealed that baseline delta-aminolevulinic synthase activity was considerably reduced, but increased six to seven fold (to normal levels) when patients' cells were exposed to pyridoxal phosphate (PLP). In both cases, ferrochelatase and delta-aminolevulinic acid dehydratase activities were normal. Bone marrow heme oxygenase showed no significant differences in activities between normals and patients values in the absence or presence of PLP. In contrast, heme synthesis by patients' bone marrow was less than that of normals. This study demonstrates that bone marrow cells from patients with this rare disorder have some disturbances in heme metabolism, whereas erythropoiesis appeared to be normal when cultured with adequate nutrients in vitro.
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ranking = 2
keywords = bone
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8/19. Severe thrombocytopenia in iron deficiency anemia.

    Mild-to-moderate thrombocytopenia has been reported as an occasional finding in patients with iron deficiency. The present case describes a multiparous woman who presented with increased menorrhagia, severe anemia (3.0 g/dl) and thrombocytopenia (9,000 platelets/mm3). Her bone marrow examination showed iron deficiency, megakaryocytopenia, and erythroid hypoplasia but no other evidence of a primary marrow disorder. Her symptoms, the thrombocytopenia and the megakaryocytopenia, resolved with iron replacement. This case demonstrates the profound degree to which thrombopoiesis can be affected in iron deficiency.
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keywords = bone
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9/19. Familial idiopathic pulmonary hemosiderosis.

    Two brothers, aged 3 and 6 years, respectively, had their pulmonary conditions diagnosed as idiopathic pulmonary hemosiderosis (IPH). Both boys had severe iron-deficiency anemia, chronic cough, hemoptysis, and exertional dyspnea, and one had recurrent epistaxis. The results of light microscopic lung histopathologic studies in both patients showed numerous hemosiderinladen macrophages and chronic interstitial pneumonitis. No specific patterns of immunofluorescence of the alveolar capillary basement membranes were found. The results of electron microscopic examinations showed intact alveolar and capillary basement membranes and no evidence of electron-dense deposits. The lack of clinical or biochemical evidence for renal disease as well as the absence of serum antinuclear and antibasement membrane antibodies excluded associated autoimmune disorders. Evaluation for milk-protein allergy was negative and neither child demonstrated a clinical response to a milk-free diet. Sequential pulmonary function studies performed over four years showed episodes of acute obstructive airway disease that correlated with pulmonary hemorrhage and mild persistent restrictive lung disease. The results of this family study suggested that some cases of IPH may have a genetic basis.
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ranking = 238.68195013285
keywords = macrophage
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10/19. ferrochelatase deficiency in the bone marrow in a syndrome of congenital hypochromic microcytic anemia, hyperferremia, and iron overload of the liver.

    Two sisters had congenital hypochromic microcytic anemia with hyperferremia, heavy iron deposits in the liver, and reduced bone marrow iron. liver ferrochelatase activity was within normal limits, but in the bone marrow ferrochelatase activity was only 20% of that in healthy controls. There were no findings suggestive of lead intoxication, sideroblastic anemia, or erythropoietic protoporphyria.
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ranking = 3
keywords = bone
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