Cases reported "Anemia, Iron-Deficiency"

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11/191. Managing anemia using laboratory trend analysis. Case study of the anemic patient.

    Proper management of the anemia of end-stage renal disease (ESRD) requires chronic monitoring of an interrelated set of variables that can affect the erythrokinetic response. In most cases, therapeutic interventions should be determined on the basis of serial trends in laboratory values, thereby providing a historical pattern of clinical response. This article reviews the rationale for using laboratory trend analysis to manage anemia. A methodology for categorizing patterns in hemoglobin and hematocrit response to identify probable causes of hypo- or hyper-response to Epoetin alfa therapy is provided. ( info)

12/191. The combined occurrence of macular amyloidosis and prurigo nodularis.

    The association of prurigo nodularis (PN) and macular amyloidosis (MA) has not been reported before. Although pruritus related frictional trauma is a well-known cause of PN, its role in the development of MA has always been questioned. We herein report two cases with chronic liver disease and iron deficiency who concomitantly developed MA and PN lesions. pruritus was the preceding factor and both lesions were confined to scratched areas. The association of two otherwise uncommon dermatoses in pruritic patients and their characteristic distribution might indicate an important role for pruritus-induced scratching in the pathogenesis of MA, too. ( info)

13/191. Tools for analyzing trends in anemia management case study of the anemic patient.

    An increasing number of dialysis facilities are empowering nurses to coordinate, monitor, and manage most aspects of anemia-related care. Careful analysis of the trends in laboratory values can provide nurses with a valuable assessment tool to guide therapeutic decisions. This article reviews several proven methods for analyzing laboratory trends and uses case studies to illustrate how to interpret these trends to identify potential etiologies that can cause hyporesponse to Epoetin alfa therapy. ( info)

14/191. Benefits of early utilization of intravenous iron.

    Better anemia management has dramatically improved the lives of many patients with end stage renal disease (ESRD). nephrology professionals frequently use two tools--erythropoietin and supplemental iron--to manage anemia. The National kidney Foundation dialysis Outcomes Quality Initiative (NKF-DOQI) suggests that most ESRD patients will need intravenous (i.v.) iron to optimize their response to erythropoietin. In this report, the author reviews published studies showing that i.v. iron reduces erythropoietin dose requirements, resulting in cost savings. She presents data from her center illustrating that i.v. administration of the newly approved Ferrlecit (sodium ferric gluconate) also improves anemia management and reduces erythropoietin dose requirements. The author reviews studies showing the efficacy of i.v. iron as monotherapy for anemia in ESRD patients. These data support the importance of i.v. iron as an agent to be used alone or in conjunction with erythropoietin in the management of anemia in patients with ESRD. ( info)

15/191. chloroquine in idiopathic pulmonary hemosiderosis. A case report.

    This report describes an 11-year-old boy with idiopathic pulmonary hemosiderosis. His only presenting symptom was severe anemia due to iron deficiency. Idiopathic pulmonary hemosiderosis was diagnosed nine years after the onset of symptoms. During this period many invasive and non-contributory investigations were performed. This report describes the patient's diagnostic problems, clinical features and dramatic improvement with chloroquine (250 mg/day) after failing to respond to megadose methylprednisolone (30 mg/kg). One year later, chloroquine was discontinued. The patient has remained in remission since March 1994. chloroquine should be used for this life-threatening condition since it is less toxic than other immunosuppressive drugs. ( info)

16/191. Blue rubber bleb nevus syndrome.

    The blue rubber nevus syndrome consists of multiple venous malformations in the skin and gastrointestinal tract associated with intestinal hemorrhage and iron deficiency anemia. Other organs may be involved. The causes of this syndrome are unknown. Its most common presentation is in the form of sporadic cases, but dominant autosomal inheritance has been described. It is a condition that affects both sexes equally, and its occurrence is rare in the black race. We present a case of this syndrome diagnosed in a 11-year-old patient. He had severe anemia and a venous swelling on the trunk. Similar lesions were found in the stomach, bowel, and on his foot. We emphasize the main clinical aspects: intestine, eyes, nasopharynx, parotids, lungs, liver, spleen, heart, brain, pleura, peritoneum, pericardium, skeletal muscles, bladder, and penis lesions, systemic complications that may occur to these patients which are thrombosis and calcification, as well as consumptive coagulopathy and thrombocytopenia that may occur within the nevi. ( info)

17/191. Pulmonary hemosiderosis with juvenile rheumatoid arthritis: a case report.

    Pulmonary hemosiderosis may rarely be associated with juvenile rheumatoid arthritis or can develop during the course of the disease. We present a three-year-old boy with severe iron deficiency anemia (without any pulmonary symptoms) and arthralgia at the time of diagnosis. Two years after the initial diagnosis he developed pulmonary hemosiderosis and pauciarticular type of juvenile rheumatoid arthritis which progressed to seronegative polyarticular juvenile rheumatoid arthritis. He responded very well to prednisolone and was maintained well on low-dose alternate-day prednisolone and naproxen sodium treatment. This is the only case of association of these two diseases in our experience in both the Pediatric rheumatology and Pediatric Respiratory Diseases Departments. ( info)

18/191. Treatment of primary defective iron-reutilization syndrome: revisited.

    We encountered two patients who presented with hypochromic-microcytic anemia and were refractory to iron therapy. The symptoms were suggestive of anemia of chronic disease (ACD); however, there was no evidence of any such disease, either inflammatory or malignant. These patients were reminiscent of patients originally described as having primary defective iron reutilization. The hematologic picture consisted of hypochromic-microcytic anemia, low serum iron, low to normal iron binding capacity, high serum ferritin, and increased bone marrow iron in the absence of ringed sideroblasts. These patients had symptomatic anemia and received danazol (200 mg orally) three times per day to which they responded very well with an increase of approximately 3 g in the hemoglobin concentration over 1 year and amelioration of their symptoms. danazol was well tolerated and did not cause any virilizing side effects. Doses were lowered in maintenance after 1 year to 200 mg once per week, and responses were sustained up to 36 months of follow-up duration. In the differential diagnosis of hypochromic-microcytic anemia, especially in postmenopausal women, one has to consider this type of treatable anemia when more common types such as iron deficiency, chronic inflammation, malignancy, sideroblastic anemia, or thalassemia have been ruled out. ( info)

19/191. Severe iron deficiency anaemia and stroke.

    Neurological complications of severe anaemia in childhood are rare. We report a case of severe iron deficiency in a child of 23 months, presenting as an acute hemiparesis. ( info)

20/191. Gluten-free diet improves iron-deficiency anaemia in patients with coeliac disease.

    Two cases of newly-diagnosed asymptomatic coeliac disease with 3 years of unexplained severe iron-deficiency anaemia are presented. Oral iron supplementation had no effect on their serum iron levels and, therefore, had no influence on their anaemia. Upper gastrointestinal endoscopy confirmed normal macroscopic findings. Duodenal biopsies revealed subtotal villous atrophy of the mucosa of the small intestine. A strict gluten-free diet led to an increase in serum iron, resolution of anaemia, and restitution of normal mucosal morphology. Thus, severe iron-deficiency anaemia associated with asymptomatic coeliac disease is responsible to gluten-free diet. ( info)
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