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A tired old lady
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Pancytopenia is a reduction in the peripheral circulation of red cells, white cells, and platelets. Generally pancytopenia is caused by decreased cell production in the marrow, or increased cell destruction by an enlarged spleen. When a reduction in all cell lines is observed, the main diseases that need to be excluded are: acute leukaemia (AML or ALL)myelodysplasia (MDS)myelomamarrow infiltration by lymphoma or solid tumoursaplastic anaemia (idiopathic, or secondary to drugs, infection, or radiation exposure)splenomegaly.
Introduction to dermatological treatment
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Most side effects can be prevented by giving 5 mg folic acid once a week (e.g. on the Friday after the methotrexate is taken on the Monday) without stopping the therapeutic effect. Patients on methotrexate must not take aspirin, diuretics, hypoglycaemics, NSAIDS, phenytoin, probenecid, sulphonamides or trimethoprim. These all increase the risk of pancytopenia.
Renal Cell Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Key sunitinib toxicities included hypertension, fatigue, diarrhea, hand–foot sensitivity, stomatitis, and skin color changes. Mild pancytopenia is common but rarely dose-limiting. Post-marketing surveillance and expanded access programs have also revealed drug-induced hypothyroidism to be common, and routine monitoring of thyroid function and supplementation when required while on treatment with sunitinib (and related agents) are recommended.
Analysis of Mean Corpuscular Volume and Red Cell Distribution Width in Patients with Aplastic Anemia
Published in Hemoglobin, 2023
Lingling Liu, Qiuhao Fu, Danfeng Zhang, Dandan Chen, Fang Wang, Rong Guo, Xinsheng Xie, Zhongxing Jiang, Jifeng Yu, Yingmei Li
The inclusion criteria were as follows: (1) age ≥14 years, (2) presence of cytopenia as previously defined, (3) laboratory tests were performed, including complete blood count, bone marrow aspirate and biopsy, bone marrow karyotype analysis and fluorescence in situ hybridization, peripheral blood smear, serum iron, ferritin, serum Vitamin B12 and folate levels, lymphocyte subsets, flow cytometry for GPI-anchored proteins to detect paroxysmal nocturnal hemoglobinuria (PNH) clone, anti-nuclear antibody and anti-double stranded DNA, liver and kidney function tests, thyroid function tests, viral detection (hepatitis A/B/C, EBV, CMV, HIV and Parvovirus B19), abdominal ultrasound and echocardiogram. If the diagnosis cannot be determined, further pertinent examinations will be conducted, including next-generation sequencing and single-nucleotide polymorphism array karyotyping. The pancytopenia diagnosis was defined and classified in 731 patients. A total of 256 subjects were diagnosed with AA, including 180 with new-onset AA and 76 with post-treatment AA (as defined treatment more than 3 months). We analyzed the hemograms of 180 newly diagnosed AA patients and 166 MDS patients as controls.
Bilateral periorbital leukemia cutis presenting as suspected cellulitis
Published in Orbit, 2022
Lalita Gupta, Melissa A. Levoska, Timmie Sharma, Kord Honda, Mark A. Prendes
Upon evaluation after transfer, the patient endorsed bilateral periorbital swelling, erythema, and tenderness and denied vision changes, diplopia, and pain with extraocular movements. Visual acuity with correction was at her baseline and measured to be 20/70 for the right eye due to a longstanding failed corneal graft and 20/40 for the left eye. There was normal ocular motility and no relative afferent pupillary defect. Examination showed edematous and erythematous nontender indurated plaques involving bilateral upper and lower eyelids and nasal bridge (Figure 1A). No vesicles were observed. Anterior segment examination was significant for corneal edema of the right eye in the setting of prior corneal graft failure and mild bilateral chemosis. The remainder of the eye examination was unremarkable. Further examination of the skin revealed other cutaneous lesions including a pink, firm papule on the right upper eyebrow and light pink nodules on the left anterior shoulder, left jawline, upper back and central abdomen. The patient was afebrile. Laboratory results were significant for pancytopenia.
Toxicities of novel therapies for hematologic malignancies
Published in Expert Review of Hematology, 2020
Florian Simon, Jorge Garcia Borrega, Paul J. Bröckelmann
The therapy for hematologic malignancies has been dominated by chemotherapeutic substances eventually combined with radiotherapy (RT) for decades and these modalities remain the standard treatment for many entities. Although associated with dose-dependent severe side effects due to the associated cell and DNA damage, many combination chemotherapies yield high response rates and curative potential in some diseases such as leukemias or Hodgkin lymphoma (HL) [1]. Well-recognized acute toxicities of conventional therapies include pancytopenia with the associated risks for fatal infections or bleeding as well as organ damage. Long-term toxicities such as impaired organ function, infertility, fatigue or second malignancies are increasing reasons for sustained morbidity and mortality after successful first-line therapy in hematologic malignancies [2].