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Fetal alloimmune thrombocytopenia
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
The optimal antenatal management of AIT is still debated in the literature. One approach consists of serial fetal platelet transfusions with antigen-negative platelets (22,23). Evaluation of the fetal platelet counts before and after these procedures reveals that platelet transfusions are effective. However, the platelet count remains normal for less than 10 days, and hence platelet transfusions must be administered weekly. This approach subjects the pregnancy to the risk of fetal loss due to repetitive invasive procedures, which is especially significant since fetuses with AIT are at increased risk for fetal exsanguination associated with cordocentesis (24). The estimated risk for fetal loss from fetal transfusion of platelets through cordocentesis is about 6% and depends on the operator’s experiences (25). A less invasive alternative involves the use of maternally administered intravenous gamma globulin (IVIG). In the pilot study of 18 patients (26), IVIG with and without steroid therapy was found to significantly increase the fetal platelet count and decrease the risk of ICH. No cases of ICH occurred in that series, in contrast to 10/21 (48%) in untreated siblings.
Diagnosis and Treatment of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
For patients with progressive deterioration of oxygenation indicators, rapid imaging progress, and excessive activation of inflammatory response, the use of glucocorticoids in the short term (3–5 days) should be considered. The dosage of methylprednisolone should not exceed 1–2 mg/kg/day. It should be noted that large doses of glucocorticoids will delay the removal of coronavirus due to immunosuppressive effects. Intestinal microecological regulators can be used to maintain intestinal microecological balance and prevent secondary bacterial infections. For severe and critically severe children, intravenous gamma globulin should be considered.
The immune and lymphatic systems, infection and sepsis
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
Michelle Treacy, Caroline Smales, Helen Dutton
The memory of previous pathogens or antigens is contained within antibodies, which have specific sites that recognise past exposure to an antigen. Antibodies are soluble gamma globulin proteins that are classed as immunoglobulins. Their function is to hold the ‘memory’ of previously experienced pathogens and to recognise them.
Albumin-Globulin Ratio Indicates the Survival Outcome of Pancreatic Cancer Cases Who Underwent Preoperative Treatment and Curative Surgical Resection
Published in Nutrition and Cancer, 2023
Masamichi Hayashi, Daigo Kobayashi, Hideki Takami, Yoshikuni Inokawa, Nobutake Tanaka, Keisuke Kurimoto, Koki Nakanishi, Shinichi Umeda, Dai Shimizu, Norifumi Hattori, Mitsuro Kanda, Chie Tanaka, Goro Nakayama, Yasuhiro Kodera
The inflammatory status also produces acute-phase protein and immunoglobulin aggregation, leading to increased serum globulin (16). Additional analysis in Supplementary Table 2 indicated that high globulin level was significantly associated with the histological result of cancer invasion of the duodenum (P = 0.032). Generally, gamma-globulin, deeply related to immune function among the globulins, is called immunoglobulin. There are five types of immunoglobulins: G, M, A, D, and E. Immunoglobulin A (IgA) is mainly responsible for gut immunity. Peyer’s patches are unique and vital immune organs localized in the intestinal wall. Primary immune cells such as dendritic cells, T cells, and B cells are concentrated in the Peyer’s patch region. These intestinal immune cell groups work together to produce IgA against the invading antigen and prevent it from entering the body. Such a mechanism may affect the association between globulin and duodenum invasion.
Clinical features and diagnostic tools in idiopathic inflammatory myopathies
Published in Critical Reviews in Clinical Laboratory Sciences, 2022
Konstantinos I. Tsamis, Constantinos Boutsoras, Evripidis Kaltsonoudis, Eleftherios Pelechas, Ilias P. Nikas, Yannis V. Simos, Paraskevi V. Voulgari, Ioannis Sarmas
In general, DM treatment follows the same principles as PM. GCs remain the cornerstone of the treatment [54]. They are used empirically as first-line therapy at a dose of 1 mg/kg/d for prednisone, while in adult patients where csDMARD co-administration is indicated, the optimal dose of GCs may be lower. Also, co-administration of csDMARDs leads to a faster response and a lower risk of recurrence and allows safer tapering of GCs [75]. In refractory cases, biological agents that target various pathways of the disease have also been used with success to prolong remission and reduce the GC dose [76]. In more persistent and life-threatening forms of the disease, intravenous gamma-globulin pulses, higher doses of intravenous GCs, and plasmapheresis may be applied [77]. Finally, rehabilitation, physical therapy, and patient education that focus on muscle performance, joint preservation, and range of motion to prevent atrophy and contractures should be incorporated in the treatment of these patients [78].
IgA nephropathy in a child: Crohn’s disease-associated or adalimumab induced?
Published in Current Medical Research and Opinion, 2022
Francesco Graziano, Martina Busè, Nicola Cassata, Vincenzo Luca Lentini, Michele Citrano
Two years after diagnosis, when he was 11-year-old, the patient presented suddenly macroscopic hematuria. For this reason he was again admitted at our Unit. No infections or allergies were reported. Urinalysis at the time showed hematuria 3+, proteinuria 2+, dysmorphic RBCs and RBC casts. No stone formation was detected. Subsequent laboratory examinations showed acute renal failure, with important increases in BUN (138 mg/dL, normal 10–50 mg/dL) and in serum creatinine (4.58 mg/dL, normal 0.30–0.90 mg/dL). Estimate glomerular filtration rate (EGFR) was 20 ml/min/1.73 m2. CRP was 2 mg/dL (normal 0–0.5 mg/dL). Hb was 8.3 g/dL, PLT was 357.000/ul, white blood cells was 8300/ul (neutrophils: 68.2%; lymphocytes: 21.2%). Serum IgA was 285 mg/dL (normal 70-400 mg/dL). Serum IgG was 1319 (normal 360–1200 mg/dL). C3 and C4 were both normal. Serum Albumin was 3 g/dL (normal 3.5–4.8 g/dL). Serum protein electrophoresis showed increased gamma globulins without peak. Antinuclear antibodies (ANA), Extractable nuclear antigen (ENA), anti double–stranded DNA (anti ds-DNA) and antineutrophil cytoplasmic autoantibodies (p-ANCA and c-ANCA), anti–glomerular basement membrane (anti-GBM) antibody and IgG and IgM anticardiolipin antibodies were unremarkable. Screening for HBV, HCV and HIV was negative. No hypertension occurred.