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Immunologically Mediated Diseases and Allergic Reactions
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Kim A. Campbell, Caroline C. Whitacre
Type II hypersensitivity (also referred to as cytotoxic hypersensitivity) is mediated by IgG or IgM antibodies that bind specifically to cell surface or extracellular matrix constituents. Antibodies bound to cell surface constituents can bind and activate complement. Complement participates in Type II hypersensitivity reactions by acting as an opsonin or by directly lysing the antibody-coated cells. Examples of Type II hypersensitivity reactions include incompatible blood transfusions, hemolytic disease of the newborn, and autoimmune hemolytic anemia. The transfusion of incompatible blood results in antibody and complement-mediated destruction of the transfused erythrocytes. Patients with autoimmune hemolytic anemia produce antibody directed against their own red blood cells. In some cases, antibodies are directed against drugs (penicillin, quinine, and sulphonamides) or drug metabolites that are bound to the erythrocyte or platelet surface. Immune complexes consisting of drug and antibody can also be adsorbed onto the RBC surface.
Novel Treatments of Autoimmune Conditions
Published in Irun R. Cohen, Perspectives on Autoimmunity, 2020
Y. Shoenfeld, Y. Tomer, O. Ben-Yehuda
High-dose IVGG has also been studied in Kawasaki disease;152 though the disease is of unknown etiology, it is thought that immunological mechanisms play a major role. The treat posed by the disease is the development of coronary artery lesions. In a multicenter controlled trial in Japan, high-dose IVGG plus aspirin was compared with aspirin alone as treatment for Kawasaki disease: coronary artery lesions developed in 42% of the aspirin-treated group, compared with 15% in the IVGG plus aspirin group. 152A successful treatment of autoimmune hemolytic anemia with high-dose IVGG was recently reported.152a
Immunohematology
Published in Gabriel Virella, Medical Immunology, 2019
Gabriel Virella, Armand Glassman
AIHDs are the result of inherent immunological mechanisms encumbering or eliminating one or more of the elements of the hematopoietic process. Immune destruction of or reduction of functioning red blood cells results in autoimmune hemolytic anemia (AIHA). Immune impairment and reduction in the number of platelets results in immune thrombocytopenia (ITP). Autoimmune neutropenia (ANP) may involve any of the myeloproliferative or lymphoproliferative cell lines including stem cells. Multiple cell lines may be involved as in Evans Syndrome.
Clinical Profile and Outcomes of Primary Immunodeficiency and Malignancy in Childhood at a Tertiary Oncology Center in Developing Country
Published in Pediatric Hematology and Oncology, 2022
Derya Özyörük, Zeliha Güzelküçük, Ayse Metin, Suna Emir, Arzu Yazal Erdem, Dilek Kacar, Ayca Koca Yozgat, Can Baris Aker, Selma Çakmakçı, Sonay Incesoy Özdemir, Neriman Sari, Meriç Kaymak Cihan, Namık Yasar Özbek, İnci Ergürhan İlhan
All patients (early and late periods) who received chemotherapy experienced with various degree neutropenia (Grade 3/4) and infections. They also experienced moderate to severe mucositis (Grade 2/3/4) and mild hepatotoxicity (grade 1/2) due to treatment. One patient had a seizure after developing inappropriate antidiuretic hormone (ADH) syndrome. One patient had developed toxoplasmosis during remission period. One patient developed Coombs positive autoimmune hemolytic anemia. One patient had chylothorax. One patient experienced recurrent herpes zoster infections and chronic active EBV infection at CSF/blood. Two other patients also had chronic active EBV infection. One patient developed severe heart failure. Two patients had polyneuropathy due to vincristine. The patient with MPO deficiency developed severe diaper rash due to candida.
Clinical, Laboratory Features and Clinical Courses of Patients with Wiskott Aldrich Syndrome and X–linked Thrombocytopenia–A single center study
Published in Immunological Investigations, 2022
Hacer Neslihan Bildik, Deniz Cagdas, Aysenur Ozturk Kura, Sevil Oskay Halacli, Ozden Sanal, Ilhan Tezcan
The clinical score of five patients in the study was 5, according to a published scoring system for WAS (Ochs et al. 2009); none of them scored 5 due to severe refractory thrombocytopenia (Mahlaoui et al. 2013). We did not have any patients with early-onset severe refractory thrombocytopenia in this study, so none of our patients were treated with thrombopoietin analogs. We treated the patients with autoimmune hemolytic anemia with transfusion, high-dose methylprednisolone, and intravenous immunoglobulin (IVIG) in line with the literature (Fan et al. 2016). HSCT was performed on one patient, one patient underwent splenectomy and one died due to GIS bleeding. Because of the severe course of immunological findings and bleeding complications, HSCT and splenectomy were carried out without applying to second-line treatment for hemolytic anemia.
Transitioning Select Chemotherapeutics to the Outpatient Setting Improves Care and Reduces Costs
Published in Oncology Issues, 2021
Since 2015 when we transitioned certain rituximab administrations to the outpatient setting, we decreased our inpatient bed stays, reduced our inpatient chemotherapy costs, and increased the use of our own specialty pharmacy for patients receiving intravenous rituximab combination regimens, as well as an increased use of this model post-implementation for standard order sets. However, not every patient receiving rituximab can be treated in the outpatient setting. Accordingly, we have developed patient restrictions for rituximab in the outpatient setting, including:Immune thrombocytopenic purpura—dose-reduced rituximab, 100 mg9.Cold agglutinin disease.Post-transplant lymphoproliferative disease.Autoimmune hemolytic anemia.Prolonged chemotherapy inpatient stays requiring continued treatment.Infusion reaction or need for rituximab desensitization.