Bone Marrow Necrosis

1995 ◽  
Vol 10 (4) ◽  
pp. 171-178 ◽  
Author(s):  
Marcel E. Conrad
Keyword(s):  
Bone Marrow ◽  
Cancer Chemotherapy ◽  
Case Reports ◽  
Blood Stasis ◽  
Pathological Finding ◽  
Vascular Occlusion ◽  
High Dose ◽  
Bone Marrow Necrosis ◽  
Clinical Illness ◽  
Lost To Follow Up

Bone marrow necrosis is regarded as an uncommon entity that is associated with a poor prognosis. However, organized studies using either bone marrow biopsy specimens or autopsy material showed that bone marrow necrosis can be demonstrated in approximately one third of specimens. It is found in a large number of both malignant and nonmalignant disorders, in addition to occurring following large exposures to radiation or high dose cancer chemotherapy. In the absence of radiation or cancer chemotherapy, it probably eventuates from either vascular occlusion or blood stasis in small blood vessels. When bone marrow necrosis is prolonged, it may be associated with the development of bone marrow fibrosis, and it may serve as a predisposing etiology for idiopathic myelofibrosis. Most patients discovered with bone marrow necrosis have few symptoms, and they are eventually lost to follow-up without evident progression or development of a clinical illness. In acute disorders and in those who undergo effective therapy, recovery appears to occur without complications. This frequently overlooked finding is the subject of many case reports in the medical literature, but it has only been rarely systematically investigated. The latter is probably warranted because of the potential role of bone marrow necrosis in the pathophysiology of a number of disorders and the paucity of information for treatment of this pathological finding.

scholarly journals Bone Marrow Necrosis in Newly Diagnosed Acute Leukemia: Two Case Reports and Review of the Literature

2017 ◽  
Vol 5 (1) ◽  
pp. 111-118 ◽  
Author(s):  
Adrien Quintela ◽  
Pierre Sujobert ◽  
Isabelle Tigaud ◽  
Sandrine Hayette ◽  
Martine Ffrench ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Acute Leukemia ◽  
Case Reports ◽  
Newly Diagnosed ◽  
Review Of The Literature ◽  
Bone Marrow Necrosis

A Variant of the Chemotherapy-Associated Erythrodysesthesia Syndrome Related to High-Dose Cyclophosphamide

DICP ◽  
1989 ◽  
Vol 23 (10) ◽  
pp. 776-779 ◽  
Author(s):  
Joy R. Matsuyama ◽  
Karl K. Kwok
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplant ◽  
Case Reports ◽  
Autologous Bone Marrow ◽  
Marrow Transplant ◽  
High Dose ◽  
Stage Iiia ◽  
Autologous Bone Marrow Transplant ◽  
Autologous Bone ◽  
Hands And Feet

A 33-year-old woman with stage IIIA non-Hodgkin's lymphoma unresponsive to ten cycles of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) developed a variant of the chemotherapy-associated erythrodysesthesia syndrome following high-dose cyclophosphamide and radiation in preparation for an autologous bone marrow transplant. The patient first complained of a new rash on her fingers and toes on day 6 after her first dose of cyclophosphamide. Unlike the previous case reports in which patients presented with a palmar-plantar erythema, this patient's rash occurred on the dorsal aspects of her hands and feet, and not on her palms and soles. After evaluation by a dermatologist she was diagnosed as having a variant of palmar-plantar erythema induced by cyclophosphamide.

Pregnancy after bone marrow transplantation.

1998 ◽  
Vol 16 (5) ◽  
pp. 1978-1985 ◽  
Author(s):  
S C Gulati ◽  
C Van Poznak
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Marrow Transplantation ◽  
English Language ◽  
Case Reports ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Gonadal Dysfunction ◽  
Desire To Have Children ◽  
Multiple Case

PURPOSE To evaluate the occurrence of pregnancy after bone marrow transplantation (BMT). DESIGN Medline literature review of reported pregnancies in the BMT population published in the English language. RESULTS Multiple case reports and a few series studies showed more than 250 offspring from BMT recipients. CONCLUSION BMT patients receive high-dose chemotherapy and often radiation, as well. These agents are associated with gonadal dysfunction and the fertility of patients after BMT is of concern because BMT patients are often young people who wish to resume a normal quality of life, which for many patients involves the desire to have children. Our experience with the successful pregnancy of one of our BMT patients led to the investigation of reported cases that showed numerous other births. The issue of counseling BMT patients about fertility, pregnancy complications, and potential birth defects is becoming increasingly complex and warrants further investigation.

scholarly journals Ochronotic Arthropathy: Two Case Reports from a Developing Country

2016 ◽  
Vol 9 ◽  
pp. CMAMD.S31560 ◽  
Author(s):  
Farooq A. Rathore ◽  
Saeed B. Ayaz ◽  
Sahibzada N. Mansoor
Keyword(s):  
Case Reports ◽  
Symptomatic Improvement ◽  
Intervertebral Disk ◽  
The Body ◽  
High Dose ◽  
Ochronotic Arthropathy ◽  
Intervertebral Disks ◽  
First Case ◽  
Lost To Follow Up

Alkaptonuria is a rare inborn error of metabolism, which is classified as an orphan disease. It is due to the lack of an enzyme homogentisate 1,2-dioxygenase, which results in an accumulation of homogentisic acid in different areas of the body, including sclera, skin, cardiac valves, articular cartilage of the large joints and intervertebral disks. We present two cases of alkaptonuria resulting in ochronotic arthropathy with advanced secondary generalized osteoarthritis, intervertebral disk calcifications, skin and scleral pigmentation. In these case reports, both patients had symptoms for >10 years before being diagnosed. Conservative management in the form of high-dose ascorbic acid, exercises, and gait aids was offered to both of them, which resulted in some symptomatic improvement in the first case, while the second case was lost to follow-up. Alkaptonuria is a rare disease, and although it does not clearly impact mortality, early diagnosis may improve the quality of life.

Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia

2021 ◽  
Vol 14 (1) ◽  
pp. e238317
Author(s):  
Nibash Budhathoki ◽  
Sunita Timilsina ◽  
Bebu Ram ◽  
Douglas Marks
Keyword(s):  
Bone Marrow ◽  
Multiorgan Failure ◽  
Rare Condition ◽  
Altered Mental Status ◽  
Fat Embolism ◽  
Bone Marrow Necrosis ◽  
Embolism Syndrome ◽  
Hb S ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Prevalence of haemoglobin sickle-β+ thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+ thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.

scholarly journals Salvage therapy of bleeding esophageal tumor by fully covered self-expandable metallic stent: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199719
Author(s):  
Sundus Bilal ◽  
Saad Muhammad Saeed ◽  
Muhammad Zeeshan Siddique ◽  
Muhammad Saqib ◽  
Shafqat Mehmood ◽  
...  
Keyword(s):  
Case Reports ◽  
Esophageal Tumor ◽  
Metallic Stent ◽  
Diverse Group ◽  
Expandable Metallic Stent ◽  
Lost To Follow Up ◽  
Expandable Metallic Stents ◽  
Tamponade Effect

The role of self-expandable metallic stents is gradually evolving for a diverse group of benign and malignant gastrointestinal tract problems, with luminal obstruction being by far the most common. Although its role in refractory variceal bleeding is well established, it has rarely been tried for tumor-related bleeding, with only a few case reports in this regard. We share our experience of successfully controlling esophageal tumor–related bleeding with the use of a fully covered self-expandable metallic stent. A 58-year-old woman with irresectable distal esophageal cancer, presented with hematemesis. Esophago-gastro-duodenoscopy revealed an obstructing esophageal tumor with diffuse oozing of blood. This was unamenable to local injection of adrenaline and hemospray; therefore, a temporary self-expandable metallic stent was parked to create a tamponade effect. This successfully stopped bleeding and the patient remained asymptomatic till discharge. However, she was lost to follow-up, and therefore, the stent was removed after a period of 5 months instead of 2 weeks.

Bing-Neel syndrome: A case reports

2020 ◽  
pp. 107815522098342
Author(s):  
Sinan Demircioğlu ◽  
Pembe Oltulu ◽  
Ganime D Emlik ◽  
Atakan Tekinalp ◽  
Özcan Çeneli
Keyword(s):  
Kinase Inhibitor ◽  
Case Reports ◽  
Rare Complication ◽  
Brain Biopsy ◽  
High Dose ◽  
Waldenström Macroglobulinemia ◽  
Dose Methotrexate ◽  
Waldenstrom Macroglobulinemia ◽  
Bruton Tyrosine Kinase ◽  
Methotrexate Treatment

Introduction Bing-Neel syndrome (BNS) is a rare complication of of Waldenström macroglobulinemia (WM) identified by involvement of central nervous system (CNS) lymphoplasmacytic cells. Case report We present a patient who was diagnosed with Bing-Neel syndrome four years after the diagnosis of Waldenström macroglobulinemia. Management & outcome The patient was admitted with neurological symptoms. There were lesions associated with WM involvement on brain imaging. The diagnosis was made by brain biopsy. High dose methotrexate treatment was given. Discussion CNS infiltrating agents such as fludarabine, methotrexate and cytarabine are often used in BNS treatment. Ibrutinib, which is a new bruton tyrosine kinase inhibitor, has recently started to be used in BNS treatment, as it has been shown to be effective and penetrate the CNS.

scholarly journals Clostridium haemolyticum Infection: A Cause of Hemolytic Anemia in a Patient with Bone Marrow Necrosis

2021 ◽  
Vol 9 (8) ◽  
pp. 1568
Author(s):  
Anne Sophie Lagneaux ◽  
Sandrine Hénard ◽  
Laure Diancourt ◽  
Emmanuelle Stein ◽  
Pierre Perez ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Obese Woman ◽  
Molecular Techniques ◽  
Significant Past Medical History ◽  
Bone Marrow Necrosis ◽  
Rdna Sequencing ◽  
Oxygen Sensitive ◽  
Bacteremic Episode ◽  
Bone Marrow Regeneration

Clostridium haemolyticum is a sporulating Gram-positive anaerobic rod that is considered to be one of the most fastidious and oxygen-sensitive anaerobes. It is a well-known animal pathogen and the cause of bacillary hemoglobinuria primarily in cattle. To date, human infections caused by C. haemolyticum have been reported in three patients with malignant underlying diseases. We present herein the case of a 30-year-old obese woman with no significant past medical history who developed bacteremia caused by C. haemolyticum with massive intravascular hemolysis associated with bone marrow necrosis and acute renal failure. Because of subculture failure, the diagnosis was made on the basis of 16S rDNA sequencing and next-generation sequencing. The patient, who had been afebrile for 20 days after a 17-day-course of antibiotics, experienced a second bacteremic episode caused by C. haemolyticum. After having been successfully treated for 42 days with clindamycin and amoxicillin-clavulanic acid, the patient developed acute myeloid leukemia as a result of bone marrow regeneration. Although uncommon in humans, infections caused by C. haemolyticum are severe and should be considered in a febrile patient who has severe hemolytic anemia. This case also highlights the importance of using molecular techniques for the identification of this fastidious anaerobic organism.

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