scholarly journals Early onset life-threatening myelosuppression after low dose of intravesical thiotepa

1982 ◽  
Vol 58 (680) ◽  
pp. 380-381 ◽  
Author(s):  
G. Agnelli ◽  
P. Gresele ◽  
M. de Cunto ◽  
A. del Favero
Keyword(s):  
Early Onset ◽  
Low Dose ◽  
Life Threatening

Early-onset pancytopenia and skin ulcer following low-dose methotrexate therapy

2008 ◽  
Vol 27 (7) ◽  
pp. 585-589 ◽  
Author(s):  
N Hocaoglu ◽  
R Atilla ◽  
F Onen ◽  
Y Tuncok
Keyword(s):  
Adverse Effect ◽  
Early Onset ◽  
Low Dose ◽  
Skin Ulcer ◽  
Initial Examination ◽  
Cutaneous Lesions ◽  
Folate Supplementation ◽  
Dose Methotrexate ◽  
Life Threatening ◽  
Severe Pancytopenia

Pancytopenia is a rare but serious adverse effect of low-dose methotrexate (MTX) sodium therapy, and this case report describes a very early-onset of pancytopenia and cutaneous lesions after three days of ingestion. A 64-year-old man was presented to Emergency Department with weakness, fever, poor appetite, nausea, and vomiting after he had had accidentally ingested MTX tablets (2.5 mg) twice a day for the last three days. On initial examination, several painful lesions in his oral mucosa and a cutaneous ulceration on his right foot were also observed. He had severe pancytopenia, poor kidney functions, and abnormal coagulation parameters. The blood level of MTX was found to be within therapeutic range. He was treated with leucovorine, intravenous antibiotics, and appropriate blood transfusions; he was discharged from hospital without any sequela. Pancytopenia associated with low-dose (cumulative dose of 15 mg in 3 days) MTX therapy had not been reported previously. The Naranjo probability scale showed pancytopenia and skin ulcer associated with low-dose MTX therapy as probable adverse reactions. Risk factors for pancytopenia such as renal insufficiency, hypoalbuminemia, low folate levels, concomitant infections, concomitant use of drugs, and folate supplementation were not identified in our patient. Although pancytopenia associated with low-dose MTX therapy is not expected as early as 3 days after initiation of the therapy, physicians should also be aware of this life threatening adverse effect during the very first days of MTX therapy for rheumatoid arthritis patients.

scholarly journals Novel HAX1 Gene Mutation in a Vietnamese Boy with Severe Congenital Neutropenia

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Tham Thi Tran ◽  
Quang Van Vu ◽  
Taizo Wada ◽  
Akihiro Yachie ◽  
Huong Le Thi Minh ◽  
...  
Keyword(s):  
Early Onset ◽  
Bacterial Infections ◽  
Complete Blood Count ◽  
Hereditary Diseases ◽  
Severe Neutropenia ◽  
Sequencing Analysis ◽  
Severe Congenital Neutropenia ◽  
Congenital Neutropenia ◽  
Direct Dna Sequencing ◽  
Life Threatening

Severe congenital neutropenia (SCN) is a rare disease that involves a heterogeneous group of hereditary diseases. Mutations in the HAX1 gene can cause an autosomal recessive form of SCN-characterized low blood neutrophil count from birth, increased susceptibility to recurrent and life-threatening infections, and preleukemia predisposition. A 7-year-old boy was admitted due to life-threatening infections, mental retardation, and severe neutropenia. He had early-onset bacterial infections, and his serial complete blood count showed persistent severe neutropenia. One older sister and one older brother of the patient died at the age of 6 months and 5 months, respectively, because of severe infection. Bone marrow analysis revealed a maturation arrest at the promyelocyte/myelocyte stage with few mature neutrophils. In direct DNA sequencing analysis, we found a novel homozygous frameshift mutation (c.423_424insG, p.Gly143fs) in the HAX1 gene, confirming the diagnosis of SCN. The patient was successfully treated with granulocyte colony-stimulating factor (G-CSF) and antibiotics. A child with early-onset recurrent infections and neutropenia should be considered to be affected with SCN. Genetic analysis is useful to confirm diagnosis. Timely diagnosis and suitable treatment with G-CSF and antibiotics are important to prevent further complication.

Expanding Contributions of Monogenic Very Early Onset Inflammatory Bowel Disease

2021 ◽  
Author(s):  
Jodie Ouahed
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Early Onset ◽  
Current Issue ◽  
Epithelial Barrier ◽  
Mevalonate Kinase Deficiency ◽  
Bowel Diseases ◽  
Life Threatening ◽  
Mucosal Homeostasis ◽  
Inflammatory Bowel

Abstract Currently over 70 genes known to be causative in very early onset inflammatory bowel disease (VEOIBD) have been identified. In the current issue of Inflammatory Bowel Diseases, 2 articles describing monogenetic forms of VEOIBD are highlighted. One describes a patient with life-threatening VEOIBD and a mutation in ITGA6, illustrating the importance of the epithelial barrier in maintaining mucosal homeostasis. The other describes the presentation and management of 10 patients with VEOIBD secondary to damaging mutations in MVK, resulting in mevalonate kinase deficiency. Though most monogenic causes of VEOIBD remain “private,” understanding the different categories of pathways affected in children with VEOIBD is critical and has already resulted in invaluable insight in the management of patients with VEOIBD and may hold strong implications for the care of IBD overall.

scholarly journals Efficiency and safety of single dose Magnesium sulphate in eclamptic convulsion

2017 ◽  
Vol 6 (7) ◽  
pp. 3058
Author(s):  
Vinaya Goudar ◽  
Rashmi Naganagoudaru
Keyword(s):  
Single Dose ◽  
Magnesium Sulphate ◽  
Urban Areas ◽  
Low Dose ◽  
Post Partum ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
Life Threatening ◽  
Clonic Seizures ◽  
Life Threatening Complication

Background: An acute and life-threatening complication of pregnancy is characterized by the appearance of tonic clonic seizures, in a patient with pre-eclampsia. Objective of the study was to study the efficacy and safety of a ‘single dose’ of magnesium sulphate in treatment of eclamptic convulsions.Methods: The present prospective study was undertaken among women aged between 18-35 years outpatient’s Department of gynecology in Karnataka Institute of Medical Sciences (KIMS) Hubli, Karnataka, India. The study was undertaken during December 2009 to November 2010.Results: The incidence of eclampsia in our study was 2.12%. Eclapmsia is more common in patients from rural (89%) as compared to urban areas (11%) in our study. In our study eclampsia is more common in unbooked cases (80%). Majority of patients (72%) in our study group were illiterates. 61%, 28% of patients had antepartum and intrapartum eclampsia respectively in our study. We had only 11 post-partum convulsions Table 2. 80% of patients in our study were more than 28 weeks of gestations. 65% of the patients had <5 episodes of convulsions. The number of convulsions did not affect the recurrence, and 35% had >5 episodes. In present study 5 Patients had Systolic Blood Pressure less than 140 mmHg. Majority (52) had more than 160 mmHg 42 had in between 140 and 160 mmHg. Diastolic arterial pressure was >110 in 81% of cases. The convulsions were controlled in 75% of women. Recurrence of convulsions occurred in 25% of women after receiving the single dose magnesium sulphate regime. In our study 75% of cases, there was no recurrence of convulsions and in 25% of cases, there was recurrence of convulsions, out of which 20 cases received low dose magnesium sulphate regime and the other 5 cases received Phenytoin regime as 2nd line of treatment.Conclusions: Hence the single dose Magnesium sulphate is safe and effective in controlling convulsions.

scholarly journals Reversal of Ketamine Induced Acute Delirium with Continuous Midazolam Infusion in a Post Extubation Child with Refractory Bronchospasm: A Case Report

2020 ◽  
Vol 26 (2) ◽  
pp. 56-59
Author(s):  
Fahisham Taib ◽  
Laila Ab Mukmin
Keyword(s):  
Low Dose ◽  
Care Setting ◽  
Tertiary Hospital ◽  
Emergence Delirium ◽  
The Past ◽  
First Case ◽  
Midazolam Infusion ◽  
Standardized Treatment ◽  
Life Threatening ◽  
The Common

Continuous ketamine infusion has been used successfully to treat severe refractory bronchospasm in children requiring mechanical ventilation in the intensive care setting. One of the common side effects known is emergence delirium. There is no standardized treatment for the ketamine-induced emergence delirium although benzodiazepine, haloperidol and dexmedetomidine have been reported to be effective in the past. A 7-year-old girl admitted to a tertiary hospital for life-threatening asthma requiring immediate intubation and ventilation. Ketamine was used as sedative and bronchodilator in anticipation of her challenging ventilation strategy. She was successfully extubated on day 8 of admission, however, she developed symptoms associated with the delirium. Successful reversal of the symptoms was achieved after 48-hour use of low dose intravenous midazolam. This was the first case reported on the reversal of ketamine-induced emergence phenomenon using low dose intravenous midazolam infusion.

Early-Onset Pneumococcal Sepsis in Newborn Infants

PEDIATRICS ◽  
1977 ◽  
Vol 60 (3) ◽  
pp. 352-355
Author(s):  
Robert Bortolussi ◽  
Theodore R. Thompson ◽  
Patricia Ferrieri
Keyword(s):  
Early Onset ◽  
Streptococcal Infection ◽  
Group B Streptococcus ◽  
Newborn Infants ◽  
Clinical Signs ◽  
Pneumococcal Sepsis ◽  
Life Threatening ◽  
Group B ◽  
Onset Group ◽  
Early Onset Group

Five infants with pneumococcal sepsis presented with respiratory distress and clinical signs of infection in the first day of life. Although there was no apparent epidemiological relationship among the patients, four of the five were seen within a 12-month period. Pneumonia, prolonged rupture of fetal membranes, and prematurity were features in these patients. Three infants died, two within 12 hours of diagnosis. Streptococcus pneumoniae was isolated from the vagina of three of the mothers; in two, the serotype was identical to that recovered from their infants. Clinical features of neonatal pneumococcal sepsis are similar to those of early-onset group B streptococcal infection. Like the group B Streptococcus, S. pneumoniae acquired from the maternal vagina is a potential life-threatening pathogen in the newborn period.

Fluoropyrimidine-induced toxicity and DPD deficiency.. A case report of early onset, lethal capecitabine-induced toxicity and mini review of the literature. Uridine triacetate: Efficacy and safety as an antidote. Is it accessible outside USA?

2019 ◽  
Vol 26 (3) ◽  
pp. 747-753 ◽  
Author(s):  
Dimitra Ioanna Lampropoulou ◽  
Konstantinos Laschos ◽  
Anna-Lea Amylidi ◽  
Ariadni Angelaki ◽  
Nikolaos Soupos ◽  
...  
Keyword(s):  
Early Onset ◽  
Dehydrogenase Deficiency ◽  
Colorectal Cancer Patient ◽  
Dihydropyrimidine Dehydrogenase ◽  
Efficacy And Safety ◽  
Review Of The Literature ◽  
Time Restrictions ◽  
Timely Access ◽  
Life Threatening ◽  
Chemotherapy Dose

Fluoropyrimidine-based regimens are among the most commonly used chemotherapy combinations for the treatment of solid tumors. Several genetic polymorphisms that are implicated with fluoropyrimidine anabolism and catabolism have been associated with the development of life-threatening toxicities. Uridine triacetate is an FDA-approved antidote for 5-fluorouracil or capecitabine overdose and early-onset, life-threatening toxicity within 96 h of last chemotherapy dose. To date, it is not accessible for Greek patients as per the current summary of product characteristic's time restrictions. We report and discuss the course and outcome of capecitabine toxicity in a 66-year-old female colorectal cancer patient with heterozygous dihydropyrimidine dehydrogenase deficiency. This paper highlights the difficulty in timely access of this lifesaving medication for Greek and possibly other European patients.

6081Efficacy and limitations of quinidine therapy in patients with Brugada Syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Mazzanti ◽  
E Tenuta ◽  
M Marino ◽  
E Pagan ◽  
M Morini ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Side Effects ◽  
High Risk ◽  
Brugada Syndrome ◽  
Low Dose ◽  
Clinical Course ◽  
High Risk Group ◽  
High Dose ◽  
Life Threatening ◽  
Patients Experience

Abstract Background Quinidine at high-dose is used in patients with Brugada Syndrome (BrS), but its efficacy to prevent life-threatening arrhythmic events (LAE) in BrS is unproven and its use is limited by side effects. Objective We assessed whether low-dose quinidine in BrS patients reduces: 1) the occurrence of a first LAE; 2) the arrhythmic burden in the high-risk group of cardiac arrest survivors. Methods We first compared the clinical course of 53 BrS patients treated with quinidine to that of 441 untreated controls, matched by sex, age, and symptoms. Furthermore, we calculated the annual incidence of LAEs off- and on-quinidine in 123 BrS patients who had survived a cardiac arrest. Results First, we compared the clinical course of 53 BrS patients treated with quinidine (i.e. “cases”: 89% males, median age 40 years) to that of 441 untreated, clinically-matched BrS patients (i.e. “controls”: 91% males, median age 41 years) present in our database of patients with inherited arrhythmias. Cases received quinidine (median dose of 450 mg per day) for 5.0±3.7 years. Quinidine was interrupted in only 3/53 cases (6%) for side effects and it conferred a nonsignificant reduction of the risk of a first LAE in cases versus controls (HR 0.74, 95% CI 0.22–2.48, P=0.62). Secondly, we calculated the annual recurrence of LAE off- and on-quinidine in 123 BrS cardiac arrest survivors, 27 of whom were treated with quinidine for 7.0±3.5 years. The annual rate of recurrent LAEs decreased significantly from 14.7% while off-quinidine to 3.9% while on-quinidine (P=0.03). Notably, recurrent life-threatening arrhythmic events were recorded in 4/27 (15%) symptomatic patients while on-quinidine. Conclusion We demonstrated for the first time in the long-term that low-dose quinidine reduces the recurrence of life-threatening arrhythmias in symptomatic BrS patients, with few side effects. Remarkably, about one-fifth of symptomatic patients experience life-threatening arrhythmias while on-treatment, suggesting that quinidine cannot replace implantable defibrillators in high-risk subjects.

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