scholarly journals Delayed Recognition of Levetiracetam-induced Pancytopenia

Author(s):  
Mohammad Ammad Ud Din ◽  
Syed Ather Hussain ◽  
Amy Bodrog

Blood dyscrasias associated with levetiracetam use can be difficult to identify, especially when other potential differential diagnoses are concurrently present. Here we present a 57-year-old man with metastatic adenocarcinoma of unknown primary origin on levetiracetam who initially presented with an in-stent thrombosis of the right external iliac vein and then developed worsening thrombocytopenia followed by pancytopenia. Levetiracetam was not identified as the culprit until other causes like platelet consumption, heparin-induced thrombocytopenia, idiopathic immune thrombocytopenic purpura, and bone marrow involvement by metastatic disease were ruled out.

2020 ◽  
Vol 8 (3) ◽  
pp. e000979
Author(s):  
Bárbara Andreia Jardim Gomes ◽  
Eilidh Gunn ◽  
Caroline Millins ◽  
Elspeth M Waugh ◽  
Gawain Hammond

An eight-year-old male neutered Jack Russell terrier presented with fever, shoulder and elbow pain and progressive right forelimb lameness. Haematology revealed a non-regenerative anaemia and marked thrombocytopenia. Radiography and CT of the thorax and abdomen revealed bilateral asymmetrical osteogenic-osteolytic changes to the scapulae, humeri, femurs, pelvis, ribs and vertebrae. Histopathology of the bone marrow of the left humerus confirmed a metastatic skeletal adenocarcinoma. This case features a presumptive manifestation of disseminated carcinomatosis of the bone marrow with a bilateral asymmetrical distribution in a metastatic adenocarcinoma of unknown primary origin. Disseminated carcinomatosis of the bone marrow should be included in the differential diagnosis with polyostotic osteolytic and osteogenic, bilateral asymmetrical lesions in the long bones, vertebrae, ribs and pelvis.


2010 ◽  
Vol 42 (3) ◽  
pp. 165-170
Author(s):  
Celina Ang ◽  
Eileen M. O’Reilly ◽  
Ghassan K. Abou-Alfa ◽  
Ali Shamseddine ◽  
Hadi Skouri ◽  
...  

2020 ◽  
Vol 44 (4) ◽  
Author(s):  
Krystallenia I. Alexandraki ◽  
Marina Tsoli ◽  
Georgios Kyriakopoulos ◽  
Anna Angelousi ◽  
Georgios Nikolopoulos ◽  
...  

1981 ◽  
Vol 71 (12) ◽  
pp. 1431-1434 ◽  
Author(s):  
S. RAJU INDUPALLI ◽  
AGOP Y. BEDIKIAN ◽  
GERALD P. BODEY

1994 ◽  
Vol 87 (10) ◽  
pp. 1419-1426
Author(s):  
Katsuhiko FUKAMOTO ◽  
Masafumi NAKAGAWA ◽  
Naoyuki KONO

2021 ◽  
Vol 11 ◽  
Author(s):  
Murilo Bonatelli ◽  
Isabella Fernandes Fornari ◽  
Priscila Neves Bernécule ◽  
Lara Esquiapatti Pinheiro ◽  
Ricardo Filipe Alves Costa ◽  
...  

IntroductionCancer of unknown primary origin (CUP) is defined as metastatic cancer without identification of the primary site. Considering that only 15–20% of patients with CUP show a favorable outcome, identifying biomarkers may help improve the clinical management of patients who do not respond well to conventional therapies. In this context, the study of the metabolic profile of CUP may pave the way to establish new biomarkers and/or therapeutic targets; therefore, this study aimed to characterize the expression of metabolism-related proteins in CUP.Materials and MethodsThe expression of monocarboxylate transporters MCT1, MCT2 and MCT4, their chaperone CD147, the glucose transporter GLUT1 and the pH regulator CAIX was evaluated by immunohistochemistry in a series of 118 CUP patients, and the results were associated with the available clinicopathological information.ResultsThe metabolism-related proteins MCT1, MCT4, CD147, GLUT1 and CAIX were expressed in a critical portion of the CUP (approximately 20 to 70%). MCT1 and CD147 were both more frequently expressed in cases with lymph nodes as metastasis dominant sites (p = 0.001) as well as in samples from lymph nodes (p <0.001 and p = 0.002, respectively), while MCT1 expression was more frequently expressed in squamous cell carcinomas (p = 0.045). A higher overall survival was observed in patients with tumors positive for GLUT1 and CAIX expression (p = 0.011 and p = 0.041, respectively), but none of the proteins was an independent prognostic factor for overall survival in multivariable analysis.ConclusionThe results suggest that a portion of CUPs present a hyperglycolytic phenotype, which is associated with higher overall survival.


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