Cases reported "anemia, hypochromic"

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1/195. Brunner's gland adenomas associated with high-output congestive heart failure.

    Brunner's gland adenoma in the third portion of the duodenum is rare and only two such cases have been reported previously. A 35-year old man presented with high-output congestive heart failure. Profound iron deficiency anemia was corrected by transfusion, allowing detection of a duodenal tumor, which proved pathologically to be a Brunner's gland adenoma. ( info)

2/195. Posthaemorrhagic iron deficiency. Clinical course, 59Fe whole-body iron losses, and oral iron supplementation.

    Clinical and laboratory data characterizing post-haemorrhagic anaemia with still normal iron stores and posthaemorrhagic iron deficiency in the manifest, latent or prelatent stage are presented. Initially, increased 59Fe whole-body iron losses (greater than 0.1-3.6%/day) returned to normal range (less than 0.1%/day) after haemostasis. Subsequently, slow increase of haemoglobin and repletion of iron stores occurred under normal diets. Manifest, latent, and prelatent iron deficiencies were corrected much more rapidly by total doses of 12.0, 10.5 and 8.0 g iron (Fe2 sulfate), respectively, when 2 X 50 mg/day were given in quick-release capsules apart from meals. ( info)

3/195. Hemoglobin Riyadh--alpha2beta2 (120(GH3)Lys replaced by Asn). A new variant found in association with alpha-thalassemia and iron deficiency.

    On a field trip toSaudi arabia (M.A.F.E.H.) in which the relationship between alpha-thalassemia and iron deficiency was studied, a fast moving hemoglobin variant was noted in a 30 year old Saudi Arabian woman. Analysis of the hemoglobin variant showed that the amino acid substitution was beta120 Lys replaced by Asn. This variant had not been described previously and has been named Hb Riyadh. There was also present an alpha-thalassemia and details are given of the imbalance of globin chain synthesis. It was possible to improve considerably the balance in vitro by the addition of hemin. ( info)

4/195. A case of progressive congestive heart failure secondary to severe anemia in a patient presenting with uterine hemorrhage.

    In this report, we present a 42-year-old female patient who was transferred to our emergency department due to symptoms of congestive heart failure. She presented with severe anemia (hemoglobin was 1.3 g dl(-1), and hematocrit was 6.0%) due to continuous uterine hemorrhage and metabolic acidosis, otherwise she seemed to be free from illness. We diagnosed that she was suffered from chronic severe anemia due to uterine hemorrhage and congestive heart failure. Monitoring her hemodynamic status, treatment of congestive heart failure using diuretics and inotropes in combination with blood transfusion brought her good recovery. We discussed this case from the mechanisms of development of congestive heart failure in a chronic severe anemic condition, and pointed out that distributive effects of sodium and water may develop congestive heart failure without myocardial dysfunction in such a condition. ( info)

5/195. 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. ( info)

6/195. Isoimmune haemolysis in pathogenesis of anaemia after cardiac surgery.

    A patient who had received multiple transfusions developed antiglobulin-positive haemolytic anaemia due to a delayed haemolytic transfusion reaction. Many cases of haemolytic anaemia after cardiac surgery could be explained on this basis. ( info)

7/195. 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. ( info)

8/195. Differential diagnosis of Hb EE and Hb E-beta(0)-thalassemia by protein and dna analyses.

    dna analysis was used to confirm the Hb EE genotype and to differentiate from the possible genotype of Hb E-beta(0)-thalassemia in two Malay patients. The first patient was a 13-year-old Malay girl, whose parents were available for family studies. The second patient was a 69-year-old Malay woman with no living family members. The presence of Hb E in both propositi was confirmed by: (1) its characteristic electrophoretic mobilities on alkaline/acid gels; (2) its chromatographic properties on anion/cation exchangers, and (3) its mildly insoluble properties. However, differential diagnosis of Hb EE and Hb E-beta(0)-thalassemia was challenging in these two cases. In the former, this was because of the possible interactions of the parents' phenotypes; i.e., the mother had a similar phenotype. In the latter, it was due to the lack of any living family members for family studies. In this communication, we present the protein and dna analyses, including data on the use of the restriction enzyme Mnl I, for the definitive diagnosis of the Hb EE genotype in the propositi of these two Malay families. ( info)

9/195. Chronic painless hematuria and urethral bleeding as the presenting manifestations of Osler-Weber-Rendu disease.

    A case of a young man with profound iron deficiency anemia, chronic painless hematuria and urethral bleeding is presented. He had the typical cutaneous findings of Osler-Weber-Rendu disease (hereditary hemorrhagic telangiectasia). Appropriate urological studies demonstrated bladder and urethral telangiectases, with no other explanation for the bleeding. Osler-Weber-Rendu disease should be considered in the differential diagnosis of chronic painless hematuria. ( info)

10/195. diagnosis of polycythemia vera in an anemic patient.

    Criteria proposed by the polycythemia vera Study Group (PVSG) as well as several derived algorithms are currently used for the diagnosis of polycythemia vera. Although these guidelines have significantly enhanced diagnostic accuracy, they uniformly consider erythrocytosis as the requisite premise for instigating the subsequent workup. We describe the unusual presentation of a patient with microcytic anemia in whom the diagnosis of polycythemia vera was reached using the PVSG criteria and confirmed by in vitro culture assay of erythroid progenitor cells. This case highlights the usefulness of the PVSG criteria, including the red cell mass determination, for the diagnosis of polycythemia vera even in anemic patients. The roles of spleen red cell pooling and plasma volume expansion as major determinants of this unusual presentation are discussed. ( info)
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