Pesticides and Chronic Diseases
William J. Rea, Kalpana D. Patel in Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
Chlordimeform (Acaron, Fundal, Fundex, Galecron, Spanone): Although the acute toxicity of this ovicidal agent is low (oral LD50 in the rat about 200 mg/kg, it is now known from an incident of excessive respiratory and dermal exposure to chlordimeform powder that it can cause acute illness and urinary bladder irritation. In all likelihood, the offending metabolite is 2-methyl-4-chloroaniline. Principal symptoms are dysuria, gross hematuria, urethral discharge, abdominal and back pain, and a hot sensation all over. Sleepiness, skin rash, anorexia, and a sweet taste in the mouth have also been reported. Cystoscopic examination of victims of excessive exposure demonstrated acute hemorrhagic cystitis. Methods are available for detecting 2-methyl-4-chloroaniline metabolite in the urine.
Cidofovir and Brincidofovir
M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson in Kucers’ The Use of Antibiotics, 2017
Although supportive care has been the standard of treatment for hemorrhagic cystitis for many years, several clinical studies have demonstrated successful use of CDV for BK virus hemorrhagic cystitis after hematopoietic stem cell transplantation not only in adults but also in children (Cesaro et al., 2013; Gaziev et al., 2010; Savona et al., 2007). Important factors in the pathogenesis of hemorrhagic cystitis involve severe immunosuppression together with urothelial damage due to conditioning and radiation (which creates a favorable environment for viral replication and leads to an augmentation in immunological signals and antigen presentation) and the attack of virus-infected urothelial cells by donor T-cells. Additional risk factors for hemorrhagic cystitis include donor origin, noncoding control region (NCCR) viral mutants, treatment with antithymocyte globulins, and type of conditioning. All these factors may influence the response to adjuvant therapies.
Intense Immunosuppression Followed by Autologous Stem Cell Transplantation in Severe Multiple Sclerosis Cases
Richard K. Burt, Alberto M. Marmont in Stem Cell Therapy for Autoimmune Disease, 2019
Mobilization was successful in all cases and generally well tolerated and a median number of 9.06 × 106/kg of CD34+ cells were collected (range 3.51-26.02 × l06/kg). However, adverse effects were observed in some cases: one patient experienced subclavian phlebitis, one transient inappropriate secretion of ADH and a third hemorrhagic cystitis. This last patient (n 13) was treated in the previous year with CY 1 gr. IV every month for 6 months, without significant clinical results. The hemorrhagic cystitis was severe and lasted almost 2 months. Nadir of polymorphonuclear cells (PMN) occurred 8 days after mobilization (range 7-11 days) and of platelets (Pit) on day 10 (range 3-13). Median days with PMN<0.5 × l09/L and Plt<50 × l09/L were 4 (range 2-4) and 0 (range 0-4), respectively.
Outcomes and risk factors of hemorrhagic cystitis in pediatric allogeneic hematopoietic stem cell transplantation recipients using different graft source and condition with severe aplastic anemia
Published in Hematology, 2022
Bohan Li, Lijun Meng, Yuanyuan Tian, Qin Lu, Li Gao, Peifang Xiao, Jun Lu, Jie Li, Lin Wan, Zhiheng Li, Shaoyan Hu, Lingjun Kong
Hemorrhagic cystitis was defined as microscopic or macroscopic hematuria and dysuria with a negative bacterial culture in the urine and no other hemorrhagic conditions. The symptoms of HC are classified as follows: grade 1 shows microscopic hematuria; grade 2, macroscopic hematuria; grade 3, macroscopic hematuria with clots, and grade 4, macroscopic hematuria with clots, urinary obstruction, kidney damage, and bladder damage [18]. Overall survival (OS) was considered as time from allo-HSCT to death. Neutrophil engraftment was defined as achieving an absolute neutrophil count ≥0.5 × 109/L for 3 consecutive days. Platelet engraftment is defined as achieving a platelet count ≥20 × 109/L without transfusion support for 7 consecutive days. Myeloablative conditioning regimen, defined as busulfan (BU) >8 mg/kg. The diagnosis and grading of acute GVHD (aGVHD) and chronic GVHD (cGVHD) were assigned by the transplant center using standard criteria [19,20]. Engraftment syndrome (ES) was defined as fever in absence of infection, skin rash, diarrhea, capillary leak syndrome, and pulmonary injury which occur before or during neutrophil engraftment [21].
An update on the safety of treating relapsing-remitting multiple sclerosis
Published in Expert Opinion on Drug Safety, 2019
Clara G. Chisari, Simona Toscano, Emanuele D’Amico, Salvatore Lo Fermo, Aurora Zanghì, Sebastiano Arena, Mario Zappia, Francesco Patti
Cyclophosphamide (CYC) is an alkylating agent, determining a cytostatic effect on proliferating T and B-lymphocytes and inducing a shift versus a Th2-immune response [218]. Despite no improvement in long-term disability progression has been reported [219], studies among RRMS patients detected a reduction or stabilization of relapse rate and MRI outcomes, with EDSS stabilization or improvement [220–223]. It is usually administered i.v. with a pulse regimen, starting with a dose of 800 mg/m2 every 4–8 weeks for 12–24 months. Dose may be fixed or augmented in order to obtain a target leukocyte count of 3000/mm3 and a lymphocyte count of 800/mm3. Induction regimen may be also employed administering 600 mg/m2 on days 1, 2, 4, 6, 8 for 8 days and then 600 mg/m2 every 4–6 weeks according to absolute leukocyte count [224]. Data from clinical trials reported alopecia, nausea and vomiting, transient myelosuppression, amenorrhea and azoospermia as common AEs. Besides, in up to 4.5% of CYC-treated patients, hemorrhagic cystitis has been reported [225,226]. An increased risk of bladder cancer has been assessed in 5.7% of chronically catheterized CYC-treated patients [227]. Myelodysplastic syndromes, lymphoma, thyroid cancer, and sarcoma can occur, even after several years from the last administration [225]. Women of childbearing age and men should use adequate contraception during treatment, which exerts teratogen effects and should be discontinued during pregnancy and breastfeeding.
Short-term Intensive Immunosuppression: A Randomized, Three-arm Study of Intravenous Pulse Methylprednisolone and Cyclophosphamide in Macular Serpiginous Choroiditis
Published in Ocular Immunology and Inflammation, 2018
Pradeep Venkatesh, Akshay Tayade, Varun Gogia, Shikha Gupta, Bhavin M. Shah, Rajpal Vohra
Patients were followed up on day 3, 1st and 2nd weeks, 2nd, 4th and 6th months, or whenever they presented symptomatically. Optical coherence tomography (OCT) (Cirrus HDOCT; Carl Zeiss Meditec, Dublin, CA) was also performed to look for formation of a subfoveal scar, choroidal neovascular membrane, and macular edema at each visit. Other investigations comprised complete blood count (CBC), to screen for leukopenia prior to starting therapy, and as a baseline measurement to note the drop in the leukocyte count after pulse immunotherapy. To assess development of hepatotoxicity and nephrotoxicity, all participants were subjected to a liver function test and renal function test, respectively, on day 7 and in 2 weeks. Patients in groups C and DCP also underwent urinalysis to detect microscopic hematuria to identify hemorrhagic cystitis, a side-effect most common with cyclophosphamide therapy at day 3 and day 7. Blood pressure measurement and blood sugar monitoring were routinely performed on each follow-up visit to rule out development of hypertension or diabetes mellitus due to prolonged systemic corticosteroid therapy. All patients were monitored for development of any episode of infections, alopecia, weight gain, body or facial swelling, and gastritis.
Related Knowledge Centers
- Adenoviridae
- Bleeding
- Dysuria
- Hematuria
- Ifosfamide
- Polymerase Chain Reaction
- Urinary Tract Infection
- Cyclophosphamide
- NONoxynol-9
- Immunodeficiency