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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.
Pneumocystis jirovecii: a review with a focus on prevention and treatment
Published in Expert Opinion on Pharmacotherapy, 2021
R. Benson Weyant, Dima Kabbani, Karen Doucette, Cecilia Lau, Carlos Cervera
Although PJP has a strong association with HIV, there are many other conditions that can cause immune suppression and predispose individuals to pneumocystis infection (Table 1). In large contrast to several decades ago, more cases of PJP are currently found in non-HIV patients than PLWH. Both hematological and solid organ malignancies can predispose to PJP, even in the absence of cytotoxic or immunologic treatment [15]. The most significant risk factor in non-HIV patients is a CD4 T-cell count less than 200 cells/μL. Other conditions that can cause lymphopenia include congenital T-cell immunodeficiencies and individuals on therapeutic immunosuppression (e.g. organ transplant recipients, those with malignancies and certain inflammatory and rheumatological conditions).
TLR4 as a therapeutic target for respiratory and neurological complications of SARS-CoV-2
Published in Expert Opinion on Therapeutic Targets, 2021
Dhriti Kaushik, Ranjana Bhandari, Anurag Kuhad
In a study on 138 patients in Wuhan, China, 56 years were the median age of patients. 54.3% of patients were men. The common symptoms were fever (98.6%), fatigue (69.6%), and dry cough (59.4%). Lymphopenia was observed in 70.3% of patients. 26.1% of patients showed complications like ARDS (61.1%), arrhythmia (44.4%), shock (30.6%) and were transferred to ICU. Patients in the ICU were older and had preexisting co-morbidities and showed more likeliness of anorexia (66.7%) and dyspnea (63.9%) [22]. Given the neurological complications, a systematic review analyzed the most common neurological manifestations to be a headache, myalgia, hypogeusia, hyposmia, and altered sensorium. The manifestations of central nervous reported were mainly ischemic stroke, encephalo-myelitis, acute myelitis, and intracerebral hemorrhage. Bell’s palsy and Guillain-Barre Syndrome were the peripheral nervous system complications reported while the skeletal muscle manifestation was mainly found to be rhabdomylosis [24].
Biomarkers associated with COVID-19 disease progression
Published in Critical Reviews in Clinical Laboratory Sciences, 2020
Giovanni Ponti, Monia Maccaferri, Cristel Ruini, Aldo Tomasi, Tomris Ozben
Yang et al. [20] reported lymphopenia in 80% of critically ill adult COVID-19 patients, whereas Chen et al. [4] reported a rate of only 25% of patients with mild COVID-19 infection. These observations suggest that lymphopenia may correlate with infection severity. Qin et al. analyzed markers related to dysregulation of immune response in a cohort of 450 COVID-19 positive patients, reporting that severe cases tended to have lower lymphocyte-, higher leukocyte-counts and higher NLR, as well as lower percentages of monocytes, eosinophils, and basophils compared to mild cases [21]. Similarly, Henry et al. also concluded in a meta-analysis on 21 studies including 3377 COVID-19 positive patients that patients with severe and fatal disease had significantly increased WBC, and decreased lymphocyte and platelet counts compared to non-severe disease and survivors [22].