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Respiratory Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Ian Pavord, Nayia Petousi, Nick Talbot
Blood tests: Lymphopenia is a sign of active disease. Erythrocyte sedimentation rate (ESR) may be increased. Serum angiotensin converting enzyme (ACE) is often increased (not a diagnostic test, but useful in disease monitoring). Serum calcium may be elevated, and renal function may be abnormal.
An Introduction to Bone Marrow Transplantation and Processing
Published in Adrian P. Gee, BONE MARROW PROCESSING and PURGING, 2020
Patients with acute GvHD have a high risk of developing a subsequent chronic form of the disorder, characterized by a generalized fibrosis, affecting skin, gastrointestinal tract, exocrine glands, biliary tree, and synovia. Lymphopenia and an increased risk of infection from bacteria, fungi, and viruses occurs. Untreated, chronic GvHD has a mortality in the order of 50%, but progression can be prevented by early administration of steroids.47 The pathophysiology of GvHD is illustrated in Figure 4.
The Compromised Host: AIDS and Other Diseases
Published in Peter D. Walzer, Robert M. Genta, Parasitic Infections in the Compromised Host, 2020
Lymphopenia in adults is defined as less than 1000 lymphocytes/mm3 (9). The clinical consequences of lymphopenia depend on which subsets are affected; regardless of the total lymphocyte count, severe infections of various types may occur if profound deficiencies of either B lymphocytes or T lymphocytes are present. Substantial reductions in helper T lymphocytes have particularly important consequences in terms of susceptibility to protozoan and helminthic infection. The most common causes of lymphopenia are hematological malignancies, corticosteroid therapy, antilymphocyte globulines, cytotoxic drugs, and infection with certain viruses such as cytomegalovirus and HIV. Congenital lymphopenias can also have severe consequences.
Human oocyte cryopreservation: revised evidence for practice
Published in Human Fertility, 2023
Virginia N. Bolton, Catherine Hayden, Michele Robinson, Dima Abdo, Angela Pericleous-Smith
The same risks of ovarian stimulation and oocyte collection apply to patients undergoing oocyte cryopreservation as to those undergoing conventional fresh IVF/ICSI treatment. In addition to the risk of OHSS, specific risks of COS for patients with cancer or benign conditions who are contemplating fertility preservation should be considered and evaluated. These include increased risk of thrombosis, for patients with malignancy and benign conditions such as inflammatory bowel disease, and of haemorrhage and infection for patients with thrombocytopaenia or lymphopaenia. Individualised risk assessment must be undertaken in the case of pelvic tumours where surgical access may be hazardous in respect of distorted anatomy or potential tumour dissemination with the standard transvaginal ultrasound-guided retrieval approach, and a trans-abdominal or a laparoscopic approach may be required.
Targetting ferroptosis for blood cell-related diseases
Published in Journal of Drug Targeting, 2022
Zhe Chen, Jinyong Jiang, Nian Fu, Linxi Chen
In the future, it is very essential to pay more attention to the study of ferroptosis in thrombosis and infectious diseases. During the global epidemic of Coronavirus disease 2019 (COVID-19), some studies indicate that iron load and ferroptosis may play a crucial role in COVID infection [121,122]. Hydrogen is recommended to the latest Chinese novel coronavirus pneumonia (NCP) treatment guidelines on account of anti-inflammatory and antioxidant ability in many clinical trials. Additionally, hydrogen can reduce the occurrence of ferroptosis by downregulating inflammatory microRNA-9 [123]. We speculates that hydrogen has an anti-inflammatory and antioxidant ability by inhibiting ferroptosis. Significantly, autopsy reveals a ferroptosis signature in T lymphocytes-infiltrated heart and lung in COVID-19 infections, suggesting that ferroptosis may be a detrimental factor in cardiac damage and multiple organ failure [124]. Other studies also reveal the decrease of lymphocytes in the blood and the occurrence of significant lymphopaenia in a large proportion of COVID-19 patients [125]. This evidence may indicate that ferroptotic death tends to decrease lymphocytes in COVID-19 patients. Furthermore, a basic study finds that the mRNA levels of GPX4 are significantly decreased in patient-derived SARS-CoV2 (SZ005)-infected African green monkey kidney (Vero) cells, which identify that ferroptosis may be activated in COVID infections [126]. Thus, ferroptosis is considered as a critical player in COVID-19 infections.
Systemic lupus erythematosus and risk of infection
Published in Expert Review of Clinical Immunology, 2020
Megan R.W. Barber, Ann E. Clarke
Susceptibility to infection is also driven by acquired immune dysregulation, with disease activity identified as an independent predictor of infection in multiple SLE cohorts [20,22,25,42]. Anti-double-stranded DNA antibody positivity, hypocomplementemia, and frequent flares are independent predictors of infection [43]. The pathophysiology is complex, and a wide array of mechanisms are involved. Disease activity can breakdown cutaneous and mucosal barriers allowing microbial entry. Immune complex formation leads to hypocomplementemia which may inhibit the complement cascade. T helper cells have a diminished response to viral antigens, which is worsened by SLE disease activity [44]. Neutropenia and lymphopenia are also associated with disease activity and may increase infection rate [45].