Diagnosis of Rare Antibody Anti-Ata in Pregnancy: A Case Report

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S152-S153
Author(s):  
Mehran Taherian ◽  
Zhonghua Liu ◽  
Melissa Petras
Keyword(s):  
Term Infant ◽  
Beta Thalassemia ◽  
Healthy Children ◽  
Hemolytic Disease ◽  
High Prevalence ◽  
High Incidence ◽  
History Of ◽  
Thalassemia Trait ◽  
Ectopic Pregnancies ◽  
Compatible Blood

Abstract Background Anti-Augustine antigen (Ata) is a high-prevalence RBC antigen, and anti-Ata is an extremely rare RBC alloantibody. Anti-Ata is usually produced by an Ata (–) individual after alloimmunization by transfusion or during a pregnancy and is associated with immediate or delayed hemolytic transfusion reactions and hemolytic disease of the fetus and newborn. We report the detection of a unique antibody to an antigen of high incidence, the anti-Ata. Case Presentation The patient was a 26-year-old African American pregnant female G7P2042 with a medical history of beta-thalassemia trait, presented at her second trimester for evaluation of abdominal cramping. The patient has had two prior ectopic pregnancies, managed surgically, and two healthy children delivered vaginally with no obstetric or congenital complications. She was treated for a pulmonary embolism a few months before while she was on OCPs. She had no prior transfusions. She also had anemia (RBC 4.1 × 1012/L, Hgb 9.7 g/dL, Hct 29.6%, MCV 72.2 fL). The patient’s blood sample was sent for type and screen, and it came positive for anti-Ata antibody. This test was performed at Memorial Blood Centers (a reference lab) and Kaleida Health Laboratories. The phenotype of our patient was c+ E+ e+ k+ Kpb+ Jsb+ Jka+ M+ N+ s+ U+ Lub+. The baby was followed with serial fetal middle cerebral arterial (MCA) Doppler assessment, without evidence of fetal anemia. The term infant was delivered by cesarean section without complications. Currently, both mother and baby are doing well. Conclusion Although anti-Ata is unlikely to cause hemolytic disease of the newborn, it is important to ensure that compatible blood is available should the mother require transfusion postdelivery.

Reappraisal of Symptoms and Signs of Uncomplicated Beta Thalassemia Trait.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3788-3788
Author(s):  
A. P. Premawardena ◽  
T. Malewana ◽  
M. Arambepola ◽  
N. F. Olivieri ◽  
D. J. Weatherall
Keyword(s):  
Thalassemia Major ◽  
Exercise Intolerance ◽  
Controlled Study ◽  
Beta Thalassemia ◽  
Costal Margin ◽  
Spleen Size ◽  
Normal Individuals ◽  
History Of ◽  
Thalassemia Trait ◽  
Symptoms And Signs

Abstract Although considered a mild disorder, beta thalassemia trait (uncomplicated by any other hematologic abnormality) has been reportedly associated with symptoms of anemia, while in other series hepatosplenomegaly has been reported as associated with this diagnosis. No controlled study has examined the symptoms and signs of individuals with beta thalassemia trait and compared these with age- and sex-matched normal individuals. We administered a questionnaire to 397 parents (67% females) of children with beta thalassemia major attending the National Thalassemia Centre in Kurunagala, Sri Lanka, and to 87 normal volunteers (90% females). All individuals underwent physical examination by the same investigator, as well as testing by automated cell counter (Coulter), and HPLC (Bio Rad). The mean age of the parents (33 years) and controls (29.5 years) was not significantly different. In parents with thalassemia trait, 20% of males and 42% of females complained of reduced exercise tolerance compared to 12.5% of males and 38% of females in the controls (P= NS). The questionnaire revealed that 41% of parents, and 36% of controls, complained of recurrent headache; 18% of parents, and 15% of controls, complained of lethargy (P=NS). A history of malaria infection was reported in 30% of parents with thalassemia trait, and in 24% of controls. Mean quality-of-life score, recorded formally by a linear analog scale, from 0 (poorest) to 10 (greatest) was 7.1 in parents and 7.2 in controls. Splenomegaly was detected in 6% of parents with beta thalassemia trait (mean spleen size 1.5 cm below the costal margin), and 5% of normal controls (mean spleen size 1 cm below the costal margin). These findings suggest that, by contrast to many reports in the older literature, in uncomplicated beta thalassemia trait there appears to be no symptoms or signs greater than those observed in a normal control population and that fatigue, lethargy, exercise intolerance, or splenomegaly in a patient with beta thalassemia trait should not be attributed to the underlying hemoglobinopathy.

Differential Diagnosis of Hypochromic Microcytic Anemia

1980 ◽  
Vol 1 (7) ◽  
pp. 196-222
Keyword(s):  
Iron Deficiency ◽  
Lead Poisoning ◽  
Microcytic Anemia ◽  
Beta Thalassemia ◽  
Age Group ◽  
Peak Incidence ◽  
Hypochromic Microcytic Anemia ◽  
Alpha Thalassemia ◽  
History Of ◽  
Thalassemia Trait

The only hypochromic microcytic anemias in young children are iron deficiency, lead poisoning, and thalassemia. Clinical features helpful in the diagnosis include the following. Iron deficiency: peak incidence from 1 to 2 years of age, diet deficient in iron, or ingestion of more than one quart of milk per day. Alpha-thalassemia trait: occurs in any age group and predominantly in Oriental, black, and Mediterranean races. Beta-thalassemia trait occurs in children more than 6 months of age and predominately in black and Mediterranean races. Lead poisoning: peak incidence from 6 months to 4 years of age and a history of pica. It occurs largely in urban children.

scholarly journals Pattern of hemoglobinopathies and thalassemia in Manipur, India

2020 ◽  
Vol 7 (3) ◽  
pp. 474
Author(s):  
Hidangmayum Dwijaraj Sharma ◽  
Konsam Biona Devi ◽  
Pravin Kumar ◽  
Ksh Birendra Singh ◽  
Diamond Princy J. ◽  
...  
Keyword(s):  
Genetic Disorders ◽  
Thalassemia Major ◽  
Average Frequency ◽  
Cross Sectional Study ◽  
Beta Thalassemia ◽  
Cross Sectional ◽  
High Prevalence ◽  
Abnormal Hemoglobin ◽  
Hereditary Persistence ◽  
Thalassemia Trait

Background: Hemoglobinopathies are the commonest genetic disorders worldwide. Thalassemia Major, Thalassemia Intermedia and Sickle Cell Disease are the major disorders that require lifelong management and are to be considered for prevention. In India, Beta-Thalassemia is prevalent across the country, with an average frequency of carriers being 3-4%.Methods: This is a cross sectional study conducted between June 2016 - May 2017 in the Department of Medicine, RIMS Imphal in 453 patients as a workup for anemia and clinically suspected cases of Hemoglobinopathy or beta thalassemia. Blood samples were collected and sent for Haemoglobin Electrophoresis using cellulose alkaline technique.Results: Among the 453 cases of the population surveyed, 35% showed the presence of abnormal hemoglobin. 16% were found to be beta thalassemia carrier, 11.69% HbE trait, 6.62% Homozygous HbE, 0.4% beta thalassemia and 0.7% had Hereditary persistence of HbF.Conclusions: High prevalence of Beta Thalassemia trait occurred more frequently than other Hemoglobinopathies. The study concludes that it is immensely important epidemiologically to explore the haemoglobin variants in Manipur so that the carriers can be detected for prevention of more serious disorder in the future generations.

Clinical and anamnestic characteristics of patients with adenomyosis, accompanied by pelvic pain syndrome

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (6) ◽  
pp. 77-80
Author(s):  
M R Orazov ◽  
V E Radzinsky ◽  
M B Khamoshina ◽  
A O Dukhin ◽  
L R Toktar ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain Syndrome ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Pelvic Pain Syndrome ◽  
Common Disease ◽  
Contributing Factors ◽  
High Prevalence ◽  
Inflammatory Processes ◽  
History Of

Pelvic pain syndrome associated with adenomyosis is a common disease in women of reproductive age. Frequency of detection in the population varies from 10 to 53%. The aim - to study the clinical and anamnestic risk factors of pelvic pain, with adenomiose. Materials and methods. The study included 120 (n=120) patients with diffuse adenomyosis with pain and painless form of the disease who underwent examination and treatment in the gynecological Department of the Central clinical hospital №6 of Russian Railways in Moscow. Each patient was provided with an individual card, which was encrypted 171 sign. The studied parameters reflected the passport and anthropometric data, information about education, social status, presence of occupational hazards, complaints, illness. Results. Burdened gynecological and somatic histories, manifested a low health index, a more pronounced hereditary a family history of neoplastic diseases are contributing factors, and high prevalence of postponed surgeries, chronic, long-term ongoing inflammatory processes of the pelvic organs to create a favorable background for the further progression of chronic pelvic pain syndrome in adenomiose.

A new approach to the logic of discovery

2007 ◽  
Vol 50 (1) ◽  
pp. 7-27
Author(s):  
Gerald Massey
Keyword(s):  
Modal Logic ◽  
Scientific Discovery ◽  
Traditional View ◽  
New Approach ◽  
Logic Of Discovery ◽  
Good Fortune ◽  
High Incidence ◽  
History Of ◽  
Deep Sense

Contending that the quest for a logic of scientific discovery was prematurely abandoned, the author lays down eight phenomena that such a logic or theory must explain: the banality of scientific discovery; the trainability of scientists; the high incidence of simultaneous discoveries; the ubiquity of relative novices; the fact of scientific genius; the barrenness of isolated workers; the incommensurability of concepts of successive theories; and the quasi-incorporation of old concepts, objects, and methods in successor theories, The author then presents a new theory or logic of discovery according to which discoveries are the termini of "tweak paths" generated when scientists "tinker" with the laws, concepts, methods, and instruments of a given theory. Tinkering and tweaking are illustrated by examples from many-valued and modal logic and from Darwinian biology. Through the history of planetary discovery, the accidental role played by luck or good fortune in some discoveries is explored, but the author emphasizes that in a deep sense serendipity is an in eliminable feature of all scientific discovery because scientists never know m advance whether their tweaks will lead to dead ends or to positive developments. The author's new theory of scientific discovery is shown to account for all eight explananda, ft also reveals science to be a more egalitarian enterprise than the traditional view of scientific discovery as ultimately inexplicable depicts it.

scholarly journals Assessment of Subclinical Renal Glomerular and Tubular Dysfunction in Children with Beta Thalassemia Major

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 100
Author(s):  
Asmaa A. Mahmoud ◽  
Doaa M. Elian ◽  
Nahla MS. Abd El Hady ◽  
Heba M. Abdallah ◽  
Shimaa Abdelsattar ◽  
...  
Keyword(s):  
Cystatin C ◽  
Kidney Injury ◽  
Thalassemia Major ◽  
Beta Thalassemia ◽  
Good Survival ◽  
Control Group ◽  
Healthy Children ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Beta Thalassemia Major

Background: A good survival rate among patients with beta thalassemia major (beta-TM) has led to the appearance of an unrecognized renal disease. Therefore, we aimed to assess the role of serum cystatin-C as a promising marker for the detection of renal glomerular dysfunction and N-acetyl beta-D-glucosaminidase (NAG) and kidney injury molecule 1 (KIM-1) as potential markers for the detection of renal tubular injury in beta-TM children. Methods: This case-control study was implemented on 100 beta-TM children receiving regular blood transfusions and undergoing iron chelation therapy and 100 healthy children as a control group. Detailed histories of complete physical and clinical examinations were recorded. All subjected children underwent blood and urinary investigations. Results: There was a significant increase in serum cystatin-C (p < 0.001) and a significant decrease in eGFR in patients with beta-TM compared with controls (p = 0.01). There was a significant increase in urinary NAG, KIM-1, UNAG/Cr, and UKIM-1/Cr (p < 0.001) among thalassemic children, with a significant positive correlation between serum cystatin-C, NAG and KIM-1 as regards serum ferritin, creatinine, and urea among thalassemic patients. A negative correlation between serum cystatin-C and urinary markers with eGFR was noted. Conclusion: Serum cystatin-C is a good marker for detection of glomerular dysfunction. NAG and KIM-1 may have a predictive role in the detection of kidney injury in beta-TM children.

scholarly journals Prevalence of MDR organism (MDRO) carriage in children and their household members in Siem Reap Province, Cambodia

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Shweta R Singh ◽  
Bunsoth Mao ◽  
Konstantin Evdokimov ◽  
Pisey Tan ◽  
Phana Leab ◽  
...  
Keyword(s):  
Final Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
E Coli ◽  
Middle Income Countries ◽  
Siem Reap ◽  
High Prevalence ◽  
Significant Public Health ◽  
History Of

Abstract Background The rising incidence of infections caused by MDR organisms (MDROs) poses a significant public health threat. However, little has been reported regarding community MDRO carriage in low- and middle-income countries. Methods We conducted a cross-sectional study in Siem Reap, Cambodia comparing hospital-associated households, in which an index child (age: 2–14 years) had been hospitalized for at least 48 h in the preceding 2–4 weeks, with matched community households on the same street, in which no other child had a recent history of hospitalization. Participants were interviewed using a survey questionnaire and tested for carriage of MRSA, ESBL-producing Enterobacterales (ESBL-E) and carbapenemase-producing Enterobacterales (CPE) by culture followed by antibiotic susceptibility testing. We used logistic regression analysis to analyse associations between collected variables and MDRO carriage. Results Forty-two pairs of households including 376 participants with 376 nasal swabs and 290 stool specimens were included in final analysis. MRSA was isolated from 26 specimens (6.9%). ESBL-producing Escherichia coli was detected in 269 specimens (92.8%) whereas ESBL-producing Klebsiella pneumoniae was isolated from 128 specimens (44.1%), of which 123 (42.4%) were co-colonized with ESBL-producing E. coli. Six (2.1%) specimens tested positive for CPE (4 E. coli and 2 K. pneumoniae). The prevalence ratios for MRSA, ESBL-producing E. coli and ESBL-producing K. pneumoniae carriage did not differ significantly in hospital-associated households and hospitalized children compared with their counterparts. Conclusions The high prevalence of ESBL-E across both household types suggests that MDRO reservoirs are common in the community. Ongoing genomic analyses will help to understand the epidemiology and course of MDRO spread.

scholarly journals Seroprevalence of Antibodies against SARS-CoV-2 in Children with Juvenile Idiopathic Arthritis a Case-Control Study

2021 ◽  
Vol 10 (8) ◽  
pp. 1771
Author(s):  
Violetta Opoka-Winiarska ◽  
Ewelina Grywalska ◽  
Izabela Korona-Glowniak ◽  
Katarzyna Matuska ◽  
Anna Malm ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Activity ◽  
Disease Activity Score ◽  
Juvenile Arthritis ◽  
Activity Score ◽  
Control Group ◽  
Healthy Children ◽  
Serum Samples ◽  
History Of ◽  
Novel Coronavirus

There is limited data on the effect of the novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) on pediatric rheumatology. We examined the prevalence of antibodies against SARS-CoV-2 in children with juvenile idiopathic arthritis (JIA) and a negative history of COVID-19 and the correlation of the presence of these antibodies with disease activity measured by juvenile arthritis disease activity score (JADAS). In total, 62 patients diagnosed with JIA, under treatment with various antirheumatic drugs, and 32 healthy children (control group) were included. Serum samples were analyzed for inflammatory markers and antibodies and their state evaluated with the juvenile arthritis disease activity score (JADAS). JIA patients do not have a higher seroprevalence of anti-SARS-CoV-2 antibodies than healthy subjects. We found anti-SARS-CoV-2 antibodies in JIA patients who did not have a history of COVID-19. The study showed no unequivocal correlation between the presence of SARS-CoV-2 antibodies and JIA activity; therefore, this relationship requires further observation. We also identified a possible link between patients’ humoral immune response and disease-modifying antirheumatic treatment, which will be confirmed in follow-up studies.

scholarly journals Rare heterotopic pregnancy after frozen embryo transfer: a case report and literature review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Xianping Wang ◽  
Ding Ma ◽  
Yangang Zhang ◽  
Yanhua Chen ◽  
Yuxia Zhang ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Left Kidney ◽  
Frozen Embryo Transfer ◽  
Heterotopic Pregnancy ◽  
Psoas Major Muscle ◽  
History Of ◽  
Gestational Sac ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Psoas Major

Abstract Background Heterotopic pregnancy occurred after frozen embryo transfer with two D3 embryos, and the case had a history of bilateral salpingectomy due to salpingocyesis. An ectopic heterotopic pregnancy was implanted in the left psoas major muscle, which has not been previously reported. Case presentation A 33-year-old woman presented with left back pain after curettage due to foetal arrest in the uterus without vaginal bleeding and spotting, and painkillers relieved the pain initially. When the painkillers ceased to work, the patient returned to the hospital. The β-human chorionic gonadotropin (β-hCG) level remained increased compared with the time of curettage, and a diagnosis of retroperitoneal abdominal pregnancy was suggested by ultrasonography and computerized tomography (CT) with the gestational sac implanted in the left psoas major muscle at the left hilum level. Laparotomy was performed to remove the ectopic pregnancy. During the operation, we carefully separated the adipose tissue between the space of the left kidney door and left psoas major muscle, peeled away the gestational sac that was approximately 50 mm × 40 mm with a 25-mm-long foetal bud, and gave a local injection of 10 mg of methotrexate in the psoas major muscle. Fifty days later, β-hCG decreased to normal levels. Conclusion It is necessary to pay more attention to the main complaints to exclude rare types of ectopic pregnancies of the pelvis and abdomen after embryo transfer.

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