scholarly journals Clinico–pathological spectrum of pancytopaenia

2021 ◽  
Vol 8 (3) ◽  
pp. 391-396
Author(s):  
Pradeep Kumar Nagaich
Keyword(s):  
Bone Marrow ◽  
Clinical Practice ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Routine Clinical Practice ◽  
Megaloblastic Anaemia ◽  
Accurate Diagnosis ◽  
Age Group ◽  
Erythroid Hyperplasia ◽  
Pedal Edema

Pancytopaenia involves reduction in all the three haematological cell lines leading to the clinical manifestations related to anaemia, leucopaenia and thrombocytopaenia. These features can manifest either alone or in different combinations. Treatment depends on the accurate diagnosis for which pathological investigations are mandatory.The study was conducted with the aims and objectives of evaluating the different clinical and haematological parameters in cases presenting with pancytopaenia. Further, the cases were further divided based on their aetiology.A total of 64 cases were included in the present study. Detailed clinical, peripheral blood and bone marrow findings were studied.Majority of the patients belonged to the age group of 16-25 years. There was a slight female preponderance in our study in the ratio of 1:1.06 for M:F. The commonest clinical presentation was generalised weakness in 55 (85.9%) cases, followed by dyspnoea in 35 (54.7%) and fever in 30 (46.9%) patients. Pallor was the commonest examination finding observed in 60 (93.8%) cases followed by pedal edema in 19 (29.7%) patients. Among RBC morphology, normocytic normochromic picture was the commonest 18(28.1%), while bone marrow finding of erythroid hyperplasia with megaloblastic maturation was observed in 20 (31.2%) patients. Overall, megaloblastic anaemia was observed in 24 (37.5%) patients.Pancytopaenia is an important haematological manifestation in routine clinical practice. Timely, early and accurate diagnosis can save many morbidity and mortalities.

scholarly journals Autoimmune thyroiditis: clinical presentation in a Nepalese population

2014 ◽  
Vol 3 (1) ◽  
pp. 44-47
Author(s):  
K Paudel ◽  
B Paudel
Keyword(s):  
Clinical Presentation ◽  
Clinical Signs ◽  
Clinical Manifestations ◽  
Primary Hypothyroidism ◽  
Cold Intolerance ◽  
Wide Range ◽  
Tingling Sensation ◽  
Pedal Edema ◽  
Antibody Levels ◽  
Hypothyroid Patients

Background: Hypothyroidism has a wide range of clinical presentations. This study was conducted to describe the clinical manifestations of chronic Hashimoto`s thyroiditis (HT) in a Nepalese population. We also tried to identify symptoms or signs characteristic for HT. Methods: During the study period, all newly diagnosed patients with hypothyroidism were interviewed about symptoms, and clinical signs were assessed. The data of hypothyroid patients were divided in two groups: TPO antibody positive and TPO antibody negative. The symptoms and signs of the two groups were analyzed and compared. Results: Among the 88 hypothyroid patients, 33 (37.5%) had positive TPO antibody levels. Female patients were more likely to be TPO antibody positive (41.3% among female and 15.4% among male). The most frequent symptoms were lethargy, cold intolerance, constipation, tingling sensation and weight gain, and the most frequent signs were facial puffiness and non-pitting pedal edema, in both groups. Statistical analysis revealed, that cold intolerance, decreased appetite and insomnia were significantly more prevalent symptoms in the TPO antibody positive group (p<0.05). Conclusion: Hashimoto`s thyroiditis is a common cause of primary hypothyroidism. It is not possible to differentiate it from the clinical presentation. Nepal Journal of Medical Sciences | Volume 03 | Number 01 | January-June 2014 | Page 68-71 DOI: http://dx.doi.org/10.3126/njms.v3i1.10362

Clinical outcomes and patient (pt) profiles in REASSURE: An observational study of radium-223 (Ra-223) in metastatic castration-resistant prostate cancer (mCRPC).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 32-32
Author(s):  
Celestia S. Higano ◽  
Fred Saad ◽  
A. Oliver Sartor ◽  
Kurt Miller ◽  
Peter Conti ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Practice ◽  
Observational Study ◽  
Clinical Outcomes ◽  
Bone Fractures ◽  
Bone Marrow Suppression ◽  
Routine Clinical Practice ◽  
Metastatic Sites

32 Background: Ra-223 is a targeted alpha therapy that showed a survival advantage and favorable safety profile in the phase 3 ALSYMPCA trial in pts with mCRPC. REASSURE (NCT02141438) is evaluating the long-term safety of Ra-223 in routine clinical practice in pts with mCRPC over a 7-year follow-up period. Methods: In this global, prospective, single-arm, observational study, the second prespecified interim analysis (data cut-off March 2019) evaluated safety and clinical outcomes of Ra-223 in pts with mCRPC. Primary outcome measures were incidence of second primary malignancies (SPM), bone marrow suppression and short- and long-term safety in pts who had ≥1 Ra-223 dose. Secondary outcomes included overall survival (OS). Results: For 1465 pts in the safety analysis, median follow up was 11.5 months. Median PSA (n=1053), ALP (n=1048), and LDH (n=555) levels at baseline were 59 ng/mL, 135 U/L, and 269 U/L, respectively. 81% of pts had bone metastases only at baseline; 19% of pts had other metastatic sites, mostly in the lymph nodes. 19% of pts had <6 metastatic sites, 47% had 6–20 sites, 20% had >20 lesions but not a superscan, and 6% had a superscan. 45%, 38%, 37%, 9%, and 8% of pts received prior abiraterone, docetaxel, enzalutamide, cabazitaxel, or sipuleucel-T as prior therapies, respectively. Median number of Ra-223 doses received was 6; 67% of pts had ≥5 doses. SPM occurred in 1% of pts. The most common treatment-emergent drug-related adverse event (AE) of any grade was diarrhea (11%). 10% of pts had a bone-associated event, 5% had fractures, and 15% had a hematological AE. Median OS was 15.6 months (95% CI 14.6–16.5). Conclusions: In REASSURE, there was a low incidence of SPM, bone fractures, and bone marrow suppression after Ra-223 treatment, with no new AEs identified. This study confirms that in routine clinical practice, Ra-223 AE rates were low, and pts generally received ≥5 doses. Clinical trial information: NCT02141438. [Table: see text]

Docetaxel in older patients for metastatic prostate cancer.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 187-187 ◽  
Author(s):  
Frances May Mark ◽  
Adam Pollard ◽  
Alastair H Thomson
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Clinical Practice ◽  
Metastatic Prostate Cancer ◽  
Age Groups ◽  
Response Rates ◽  
Routine Clinical Practice ◽  
Age Group ◽  
Psa Response ◽  
Castrate Resistant

187 Background: Docetaxel use has led to a significant prolongation in overall survival in metastatic prostate cancer (MPC). There is however limited information on treatment tolerance and outcomes in patients 80 years old and over in routine clinical practice. With the ever aging population it is becoming more important to assess outcomes in this age group. Methods: Patients diagnosed with MPC and treated with docetaxel from 2006 to 2016 were identified and their records retrospectively reviewed via electronic clinical and prescribing systems in a single centre in the UK. Data was assessed for prostate specific antigen (PSA) response, number of cycles and dosing of docetaxel and castrate resistant overall survival (OS). Results: 209 consecutive patients with MPC receiving docetaxel were reviewed. Three patient groups were identified; younger than 75 years old (n = 150, 37 early (as part of initial therapy) docetaxel), 75-79 years (n = 40, 2 early docetaxel) and 80 years or over (n = 19, no early docetaxel). When comparing mean OS excluding early docetaxel treatment, respective mean survival times for each of the three age groups, younger to older were 1001, 1045 and 1294 days, with between class difference being insignificant. The PSA response rates to docetaxel excluding first line use were compared between the age groups and did not show a significant difference at 39% in the youngest group, 38% in the intermediate age group and 42% for the oldest patients. There was a trend that the older the patient, the more likely docetaxel was the final systemic treatment given at 42% (80 years or over), 32% (75-79 years) and 23% (younger than 75 years). The 80 years or over group received fewer docetaxel cycles (3.8, p = 0.006) and less dose per course (226mg/m2, p = 0.004) than the group less than 75 years (5.8 cycles, 409mg/m2) and 75-79 years (5.1 cycles, 341mg/m2). Conclusions: In this group of patients, in routine clinical practice, the 80 years and over age group received fewer cycles of docetaxel in MPC and less dose per course, but nevertheless achieved similar PSA response rates and castrate resistant OS. Given these results, docetaxel should be considered as a treatment option in suitable patients of 80 years and over.

scholarly journals Acute lymphoblastic leukemia

2018 ◽  
Vol 1 (1) ◽  
pp. 1-5
Author(s):  
Francisco Fabian Granados Romero ◽  
Enma maría Guadamud Lorenti
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukemia ◽  
Bone Marrow Aspirate ◽  
Lymphoblastic Leukemia ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Leukemic Cells ◽  
Age Group ◽  
Acute Leukemias ◽  
Hematologic Neoplasm

Acute lymphoblastic leukemia is the most common hematologic neoplasm in pediatric age. Acute lymphoblastic leukemia (ALL) comprises 80% of all acute leukemias in this age group. Although the etiology is unknown, some genetic, viral and environmental predisposing factors have been detailed. The clinical manifestations are usually the result of bone marrow by leukemic cells (anemia, thrombopenia and neutropenia). The diagnosis is made by morphological, cytogenetic and molecular analysis of bone marrow aspirate. The treatment lasts about two years. The prognosis of children with acute lymphoblastic leukemia has improved brilliantly in recent decades thanks to new drugs and treatment tailored to patients' risk.

scholarly journals Clinical profile of patients with pancytopenia in a tertiary care centre

2018 ◽  
Vol 6 (4) ◽  
pp. 1187
Author(s):  
Jyotsana . ◽  
Khan Afreen ◽  
Vishakha Sharma ◽  
Prem Kapur ◽  
Smita Manjavkar ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Early Diagnosis ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Megaloblastic Anaemia ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Common Cause ◽  
Appropriate Treatment ◽  
One Year

Background: Pancytopenia is a condition in which all three cell lines i.e. erythroid, myeloid and megakaryocytic are affected resulting in anaemia, leukopenia and thrombocytopenia. It can be a manifestation of a wide variety of disorders which primarily or secondarily affect the bone marrow. Early diagnosis of these conditions will help in implementing the appropriate treatment. The objective of the study was to know the clinical presentation and etiology of patients presenting with pancytopenia.Methods: A one year study from April 2016 to March 2017 was conducted in the department of medicine at a tertiary care centre. Total 32 patients with pancytopenia were studied to determine their clinical features and etiology through relevant investigations.Results: Our study revealed megaloblastic anaemia (46.87%) as the most common cause of pancytopenia, followed by malaria (12.5%). Other causes included hypothyroidism (6.2%), hypersplenism (6.2%), drugs (12.5%) and miscellaneous (9.43%).Conclusions: Megaloblastic anaemia was found to be the major cause of pancytopenia in patients. Other causes of pancytopenia were malaria, drugs, hypersplenism and hypothyroidism. These should be kept in mind while evaluating patients with pancytopenia.

scholarly journals Pediatric COVID-19 presenting as supraglottitis with vocal cord hypomobility

2021 ◽  
Vol 9 ◽  
pp. 2050313X2198946
Author(s):  
Meghana Nadiger ◽  
Manette Ness-Cochinwala ◽  
Carolina Sanchez-Vegas ◽  
Prithvi Sendi ◽  
Brian Ho ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Severe Acute Respiratory Syndrome ◽  
Vocal Cord ◽  
Multidisciplinary Team ◽  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Upper Airway ◽  
The United States ◽  
Age Group

In the United States, an estimated 7.3% of confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) are among persons aged less than 18 years. Data regarding clinical manifestations in this age group are still evolving. An upper airway predilection has been reported in children. We describe the case of a 15-year-old female with supraglottitis and unilateral hypomobility of vocal cord with concern for critical airway, associated with COVID-19. She was managed by a multidisciplinary team including critical care, infectious diseases, and otolaryngology. This report adds to the sparse but evolving body of literature on the clinical presentation of COVID-19 disease in children.

scholarly journals Anomalies of the branchial arch apparatus in children: case series and review of literature

2018 ◽  
Vol 4 (6) ◽  
pp. 1517
Author(s):  
Neha Jain ◽  
Ruchima Dham ◽  
Shama Shishodia ◽  
Nidhi Mahajan
Keyword(s):  
Clinical Practice ◽  
Clinical Presentation ◽  
Case Series ◽  
Branchial Arch ◽  
Age Group ◽  
Pediatric Age ◽  
Review Of Literature ◽  
Pediatric Age Group ◽  
Embryonic Life ◽  
Branchial Anomalies

<p>Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are five mesodermal arches separated by invaginations of ectoderm and endoderm. Branchial anomalies are result of aberrant embryonic development and are rarely seen in clinical practice. The objective of this article is to present few cases of branchial arch anomalies and to discuss the clinical presentation, diagnosis and surgical approach of such lesions in pediatric age group.</p>

scholarly journals Detection of Tumor Cells in Bone Marrow, Peripheral Blood and Lymph Nodes by Automated Imaging Devices

2006 ◽  
Vol 28 (4) ◽  
pp. 141-150
Author(s):  
Wilma E. Mesker ◽  
Hans Vrolijk ◽  
Willem C. R. Sloos ◽  
Rob A. E. M. Tollenaar ◽  
Hans J. Tanke
Keyword(s):  
Bone Marrow ◽  
Clinical Practice ◽  
Lymph Nodes ◽  
Tumor Cells ◽  
Peripheral Blood ◽  
Prognostic Value ◽  
Routine Clinical Practice ◽  
Automated Imaging

The presence of tumor cells in bone marrow, peripheral blood and lymph nodes has proven its clinical and prognostic value. Since the frequency of these cells in bone marrow and blood is sometimes as low as 1 per million and due to the fact that for the analysis of lymph nodes many sectioning levels have to be analyzed, automated imaging devices have been suggested as an useful alternative to conventional manual screening of specimens. The aim of this paper is to review the performance of current equipment that is commercially available, based on literature published so far. Requirements for introducing this equipment for routine clinical practice are discussed.

scholarly journals Frequency of causes of pancytopenia in a private hospital in Kathmandu

2013 ◽  
Vol 11 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Suspana Hirachand ◽  
R Singh ◽  
S Lama
Keyword(s):  
Bone Marrow ◽  
Aplastic Anaemia ◽  
Private Hospital ◽  
Complete Blood Count ◽  
Bone Marrow Aspiration ◽  
Metastatic Tumor ◽  
Peripheral Blood Smear ◽  
Megaloblastic Anaemia ◽  
Erythroid Hyperplasia ◽  
Common Causes

Background: Pancytopenia is not a disease entity but a triad of findings that result from a number of disease processes. These disorders may affect bone marrow either primarily or secondarily, resulting in the manifestation of pancytopenia. Objective: To identify the various causes of pancytopenia in patients attending to Star hospital, Kathmandu, Nepal. Methods: Fifty two patients with pancytopenia were included in this study from June 2011 to June 2012. Complete blood count, peripheral blood smear, bone marrow aspiration and trephine biopsies were performed according to standard methods. Results: Out of 52 cases, there were 26 cases(50%) of aplastic anaemia, 18 cases(34.61%) of megaloblastic anaemia, 4 cases(7.69%) of acute leukemia, 2cases(3.84%) of erythroid hyperplasia, 1 case(1.92%) of metastatic tumor and 1 case(1.92%) of multiple myeloma. Conclusion: Aplastic anaemia and megaloblastic anaemia were the most common causes of pancytopenia in this study. Health Renaissance, January-April 2013; Vol. 11 No.1; 134-137 DOI: http://dx.doi.org/10.3126/hren.v11i2.8220

Radiation Sickness after Therapeutic Administration of 806 mCi of 131I for Thyroid Cancer

1967 ◽  
Vol 06 (02) ◽  
pp. 170-183
Author(s):  
K. Šilink ◽  
J. Němec ◽  
J. Kubal ◽  
S. Röhling ◽  
S. Vohnout
Keyword(s):  
Bone Marrow ◽  
Thyroid Cancer ◽  
Radiation Injury ◽  
Clinical Course ◽  
External Irradiation ◽  
Bone Marrow Depression ◽  
Erythroid Hyperplasia ◽  
Cytological Features ◽  
Haematological Changes ◽  
Therapeutic Administration

SummaryThe clinical course and the haematologic events in a patient suffering from metastatic thyroid cancer after administration of 806 mCi of 131I are described. A serious bone marrow depression developed and was treated successfully. The haematological changes during the early and late phases of the radiation injury were studied in detail and compared with those after external irradiation. The haematological events after internal irradiation with 131I are characterised by initial neutrophilic leukocytosis, protracted lymphopenia, slowly developing anaemia reaching lowest values about 3 months after administration, erythroid hyperplasia in the bone marrow after recovery from bone marrow depression and prominent cytological features of the bone marrow, especially pronounced erythropoietic polyploidy.

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