Immunologically Mediated Diseases and Allergic Reactions
Julius P. Kreier in Infection, Resistance, and Immunity, 2022
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.
Rare primary extranodal sites (genitourinary, adrenal, cardiac, meningeal, esophageal, pancreatic, gall bladder, and soft tissue lymphomas)
Franco Cavalli, Harald Stein, Emanuele Zucca in Extranodal Lymphomas, 2008
Three-quarters of the cases of primary lymphoma of the uterine cervix occur in premenopausal women, with most patients being 20–50 years old.6 Affected women usually have a progeny, but cases in nulliparous women do occur. The condition presents with bleeding in 70% of the patients, sometimes accompanied by dyspareunia or pelvic pain.6 Hematuria caused by bladder involvement is less common. The disease is sometimes discovered incidentally in the course of a routine gynecological assessment, or when atypical lymphoid cells are detected on a routine PAP (Papanicolaou) smear. Cervical lymphoma can clinically resemble a squamous cell carcinoma and thus, risks to be approached therapeutically with a radical surgery, emphasizing the need for a careful preoperative evaluation since surgery is usually not necessary for lymphoma. Cervical lymphoma presents also as an obstructing mass in pregnant women, impeding the delivery. Rare cases were discovered during the work-up of autoimmune hemolytic anemia.6
Novel Treatments of Autoimmune Conditions
Irun R. Cohen in Perspectives on Autoimmunity, 2020
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
Transitioning Select Chemotherapeutics to the Outpatient Setting Improves Care and Reduces Costs
Published in Oncology Issues, 2021
Ali Mcbride, Daniel Persky
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.
The First Purine Nucleoside Phosphorylase Deficiency Patient Resembling IgA Deficiency and a Review of the Literature
Published in Immunological Investigations, 2019
Saba Fekrvand, Reza Yazdani, Hassan Abolhassani, Javad Ghaffari, Asghar Aghamohammadi
Autoimmune phenomena including hemolytic anemia, idiopathic thrombocytopenic purpura, autoimmune neutropenia, systemic lupus erythematous, sclerosing cholangitis, pericarditis and arthritis are another clinical manifestations among PNP-deficient patients (Buckley, 1994). Our patient was diagnosed with autoimmune hemolytic anemia. Similar to our patient, 13 other cases have been reported with hemolytic anemia (Dalal et al., 2001; Delicou et al., 2007; Dror et al., 2004; Kiykim et al., 2016; Moallem et al., 2002; Parvaneh et al., 2007; Rich et al., 1979, 1980; Simmonds et al., 1987; Somech et al., 2013, 2012; Walker et al., 2011). Thus, the presence of autoimmune disorders especially hemolytic anemia in immunodeficient patients with impaired cellular and humeral is an important clue for considering PNP deficiency.
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.
Related Knowledge Centers
- Acrocyanosis
- Antibody
- Blood Transfusion
- Cold Agglutinin Disease
- Shortness of Breath
- Pallor
- Red Blood Cell
- Antigen
- Lupus
- Medical Subject Headings
- Shortness of Breath