Cases reported "Neutropenia"

Filter by keywords:



Filtering documents. Please wait...

1/27. 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 = 1
keywords = alternative
(Clic here for more details about this article)

2/27. Alternative medicine in gynecologic oncology: A case report.

    A patient with Stage IIB squamous cell cancer of the cervix presented 10 days into her primary radiation therapy with neutropenic fever and diarrhea requiring hospitalization and delay in treatment. The patient's history revealed extensive use of alternative therapies including potential toxic botanicals. This case raises the possibility that a patient's use of alternative therapies may have caused toxicity and delayed primary therapy. Gynecologic oncology patients may be using alternative therapies justifying the need for incorporating this classification into the historical exam.
- - - - - - - - - -
ranking = 3
keywords = alternative
(Clic here for more details about this article)

3/27. G-CSF plasma levels in clozapine-induced neutropenia.

    BACKGROUND: Clinical reports emphasize the therapeutic usefulness of granulocyte colony-stimulating factor (G-CSF) in clozapine-induced granulocytopenia. Only sparse information exists, however, on the natural course of endogenous G-CSF plasma levels in this condition. methods: We monitored G-CSF and white blood cell (WBC) counts in a 73-year-old patient who developed granulocytopenia while being treated with clozapine for schizoaffective disorder. clozapine treatment was discontinued immediately, and G-CSF serum levels were determined repeatedly during the clinical course. RESULTS: Whereas WBC counts increased again within 6 days after discontinuation of clozapine, G-CSF level decreased significantly within the same period. The rapid decrease of endogenous G-CSF levels paralleled by a normalization of neutrophil count was interpreted as the result of an intact regulatory mechanism of granulocytopoesis. Therefore G-CSF therapy was not initiated. Owing to lack of therapeutic alternatives, it was decided to reintroduce clozapine. G-CSF levels decreased further, accompanied by an increase of WBCs, indicating stable bone marrow functioning. CONCLUSIONS: Based on this observation, we assume that the course of G-CSF and WBC counts indicated an abortive form of toxic bone marrow damage with subsequent recovery. We conclude that monitoring of G-CSF levels may serve as a useful tool in the follow-up of patients in whom clozapine-induced bone marrow damage is suspected.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

4/27. Probable colchicine-induced neutropenia not related to intentional overdose.

    OBJECTIVE: To report a case of neutropenia caused by colchicine not associated with intentional overdose or with preceding severe gastrointestinal symptoms. CASE SUMMARY: A 68-year-old white man was admitted to the hospital with intractable pain from an acute attack of gout. The patient was treated with standard doses of oral colchicine for several days. He experienced mild loose stools, but no severe diarrhea or nausea during treatment. The patient then developed severe neutropenia, with an absolute neutrophil count of 240 cells/mm3. His white blood cell count returned to normal after discontinuing colchicine and administering filgrastim. DISCUSSION: Although colchicine is commonly associated with neutropenia in cases of intentional or accidental overdose, the patient developed this adverse effect after being treated with doses commonly used for the acute treatment of gout. In addition, this patient had taken low-dose colchicine for many years without experiencing hematologic adverse effects. CONCLUSIONS: colchicine is often an attractive alternative to nonsteroidal antiinflammatory agents for the treatment of gout, especially in patients at risk for renal impairment or gastropathy. Our case illustrates that colchicine treatment can cause hematologic adverse effects; the clinician should monitor cell counts in patients receiving this agent, especially at the higher doses used for acute treatment of gout.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

5/27. Management of a pregnant patient with Graves' disease complicated by thionamide-induced neutropenia in the first trimester.

    A 31-year-old woman presented with neutropenia due to thionamide drug therapy for Graves' disease. She also reported 8 weeks of amenorrhoea and had a positive pregnancy test. Her drug therapy was discontinued and her neutropenia resolved uneventfully. The hyperthyroidism recurred a week later. After consideration of all treatment options, it was decided to observe until 14 weeks when an elective thyroidectomy was planned. Mother and fetus were monitored closely and both tolerated moderate hyperthyroidism well. At 14 weeks the patient underwent a total thyroidectomy after rendering her euthyroid with a short course of sodium ipodate. Labour was induced at 41 weeks. Delivery was complicated by fetal distress and precipitated a forceps delivery. A 3250 g male infant was born with poor apgar score and required 2 h of ventilation. At 1 year, the child had reached all developmental milestones at appropriate times. Both mother and fetus may tolerate moderate thyrotoxicosis well in early pregnancy, an alternative that should be considered when thionamide drug therapy is contraindicated.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

6/27. Sustained remission of platelet counts following monoclonal anti-CD20 antibody therapy in two cases of idiopathic autoimmune thrombocytopenia and neutropenia.

    Idiopathic autoimmune thrombocytopenia and neutropenia (ITN) is a primary haemocytopenic disorder clinically characterised by recurrent mucocutaneous bleeding episodes and infections. Unlike in simple idiopathic thrombocytopenic purpura, the platelet deficiency of ITN tends to be chronic and difficult to treat. We describe two patients with ITN who obtained sustained remission of their platelet counts after therapy with the chimeric monoclonal anti-CD20 antibody Rituximab. In one of two cases, Rituximab also induced prolonged normalisation of the neutrophil count and disappearance of auto-antibodies. Our observations indicate that disturbed B-cell function plays a central role in the pathogenesis of ITN. Anti-CD20 antibody therapy seems to constitute a safe and efficient alternative to corticosteroids for the management of ITN patients with chronic thrombocytopenia.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

7/27. Effective hemostasis with rFVIIa treatment in two patients with severe thrombocytopenia and life-threatening hemorrhage.

    We report two patients with severe thrombocytopenia and life-threatening bleeding that were successfully managed with recombinant activated factor vii (rFVIIa). The first was a 75-year-old male with Waldenstrom's macroglobulinemia. During a therapeutic course with fludarabine, he developed severe autoimmune thrombocytopenia resistant to conventional treatment, followed by persistent uncontrollable nasal bleeding. Platelet transfusions failed to increase the platelet count and control the hemorrhage. When hemoglobin levels fell below 8.5 g/dL and the patient's clinical condition got much worse, a single dose of 4.8 mg rFVIIa (90 microg/kg) was given as an i.v. bolus. Ten minutes after the rFVIIa injection, nasal bleeding stopped, the patient's clinical condition progressively improved, and splenectomy could be carried out uneventfully 2 days later. The second patient, a 52-year-old female, was under treatment for pre-B lymphoblastic leukemia. She developed severe thrombocytopenia, secondary to chemotherapy, complicated by massive gastrointestinal bleeding. Despite intensive treatment with platelet transfusions, hemorrhage continued and her condition deteriorated rapidly. She was then given an i.v. bolus injection of 4.8 mg rFVIIa, which resulted in cessation of hemorrhage and dramatic improvement of her clinical status. No adverse effects from the treatment with rFVIIa were observed. In conclusion, rFVIIa appears to be an attractive alternative for controlling hemorrhage in patients with severe thrombocytopenia, especially when platelet transfusions are unavailable or ineffective.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

8/27. Insights into leukocyte adhesion deficiency type 2 from a novel mutation in the GDP-fucose transporter gene.

    Leukocyte adhesion deficiency type 2 (LADII) is characterized by defective selectin ligand formation, recurrent infection, and mental retardation. This rare syndrome has only been described in 2 kindreds of Middle Eastern descent who have differentially responded to exogenous fucose treatment. The molecular defect was recently ascribed to single and distinct missense mutations in a putative Golgi guanosine diphosphate (GDP)-fucose transporter. Here, we describe a patient of Brazilian origin with features of LADII. Sequencing of the GDP-fucose transporter revealed a novel single nucleotide deletion producing a shift in the open-reading frame and severe truncation of the polypeptide. Overexpression of the mutant protein in the patient's fibroblasts did not rescue fucosylation, suggesting that the deletion ablated the activity of the transporter. Administration of oral L-fucose to the patient produced molecular and clinical responses, as measured by the appearance of selectin ligands, normalization of neutrophil counts, and prevention of infectious recurrence. The lower neutrophil counts paralleled improved neutrophil interactions with activated endothelium in cremasteric venules of nonobese diabetic/severe combined immunodeficiency (NOD/SCID) mice. However, fucose supplementation induced autoimmune neutropenia and the appearance of H antigen on erythrocytes, albeit without evidence of intravascular hemolysis. The robust response to fucose despite a severely truncated transporter suggests alternative means to transport GDP-fucose into the Golgi complex.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

9/27. Successful treatment of candida krusei infection with caspofungin acetate: a new antifungal agent.

    OBJECTIVE: Systemic fungal infections have high mortality, and therapy is often toxic. Caspofungin acetate, a new antifungal agent with minimal toxicity, may provide a better alternative to typical therapy for candida krusei. DESIGN: Case report. SETTING: Multidisciplinary intensive care unit (ICU) of a community teaching hospital. PATIENT: A 22-yr-old male with acute lymphoblastic leukemia and candida krusei fungemia failed therapy with fluconazole and amphotericin b. INTERVENTIONS: Caspofungin acetate given intravenously as a 70-mg loading dose, followed up by 50 mg daily along with standard ICU care. RESULTS: survival without toxicity from therapy. CONCLUSION: Efficacy of caspofungin acetate in a patient with life-threatening candida Krusei infection.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)

10/27. Successsful voriconazole treatment of disseminated fusarium infection in an immunocompromised patient.

    fusarium infection is known to cause major morbidity and mortality in immunocompromised hosts. We report the successful treatment of disseminated fusarium infection with skin manifestations in a severely neutropenic, immunocompromised host with voriconazole, a new second-generation triazole. Voriconazole might be an alternative therapy for patients with neutropenia who have fusariosis that is refractory or unresponsive to amphotericin b or its liposomal formulation.
- - - - - - - - - -
ranking = 1
keywords = alternative
(Clic here for more details about this article)
| Next ->


Leave a message about 'Neutropenia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.