scholarly journals Association of azathioprine and prednisone in the control of immunomediated hemolytic anemia in dogs / Associação de prednisona e azatioprina na terapêutica de cães portadores de anemia hemolítica imunomediada

2021 ◽  
Vol 4 (2) ◽  
pp. 2777-2784
Author(s):  
Rodrigo Prevedello Franco ◽  
Ana Flávia Mendonça ◽  
Thaís Yuri Nakamura ◽  
Thainá Pires dos Santos Sauniti ◽  
Beatriz Teixeira Martuchi
Keyword(s):  
Side Effects ◽  
Hemolytic Anemia ◽  
Clinical Manifestations ◽  
Clinical Effects ◽  
Intravascular Hemolysis ◽  
Immune Mediated ◽  
Progressive Weight Loss ◽  
Veterinary Hospital ◽  
Chronic Use ◽  
Pharmacological Association

Immune-mediated hemolytic anemia (IMHA) is an immunological disease, in which the immune-mediated destruction of erythrocytes occurs, leading to a prominent drop in globular volume (GV). The diagnosis of the disease must be made through the association of clinical manifestations with specific complementary exams, with therapy aimed at inhibiting intravascular hemolysis in the control of GV. The present study aims to report the therapeutic association of prednisone and azathioprine in the control of IMHA in two dogs, demonstrating its evolution and the clinical effects of the pharmacological association. At the Veterinary Hospital of UNIMAR, a canine, female, Blue Heeler breed, seven years old and a canine, male, Border Collie breed, seven months old, both showing apathy, hyporexia, progressive weight loss, regenerative anemia, leukocytosis, and test of positive saline autoagglutination. After IMHA was diagnosed, polytherapy with prednisone (2mg/kg/SID) associated with azathioprine (2/mg/kg/SID) was instituted. Initially, the first animal showed liver damage due to the side effects of the drugs. As for the control of IMHA, the two animals described showed improvement and stabilization of the clinical and hematological condition after the association, making it possible to reduce the dosages of both drugs without worsening the conditions and ceasing the side effects caused by the chronic use of the drugs. Through this report it is possible to conclude that the use of the therapeutic combination of prednisone and azathioprine for the control of IMHA has greater benefits, being possible to use lower doses of both drugs, reducing their side effects and, consequently, resulting in a better survival. 

scholarly journals DIAGNOSIS AND TREATMENT OF A CAT WITH IMMUNE MEDIATED HEMOLYTIC ANEMIA (IMHA)

2021 ◽  
Vol 6 ◽  
pp. 7-12
Keyword(s):  
Hemolytic Anemia ◽  
Laboratory Tests ◽  
Treatment Process ◽  
Clinical Manifestations ◽  
Symptomatic Treatment ◽  
Diagnosis And Treatment ◽  
Parasitic Infections ◽  
Routine Diagnosis ◽  
Immune Mediated

In order to explore the diagnosis and treatment of immune-mediated hemolytic anemia (IMHA) in cats, we diagnosed and treated a cat with IMHA. We made a detailed observation and record of the treatment process for reference to the treatment of IMHA in cats. Our diagnosis was based on the cat’s clinical manifestations, routine diagnosis, laboratory tests, and ultrasound results. We excluded the possibility of common infectious diseases and parasitic infections. The cat was initially diagnosed with hemolytic anemia, fatty liver, hepatocyte injury and cholestasis. The condition did not improve after symptomatic treatment for five days. But the cat gradually improved after the use of immunosuppressants, and was finally diagnosed to be suffering from IMHA. After 32 days of treatment, the cat was basically cured and discharged from the hospital. This paper describes a case study which can serve as the reference for the diagnosis and treatment of feline IMHA.

scholarly journals Complete Remission of Associative Immune-Mediated Hemolytic Anemia in a Dog Following Surgical Resection of Intestinal Leiomyosarcoma

2019 ◽  
Vol 6 (2) ◽  
pp. 55
Author(s):  
Masashi Yuki ◽  
Eiji Naitoh
Keyword(s):  
Complete Remission ◽  
Surgical Resection ◽  
Hemolytic Anemia ◽  
Immunosuppressive Treatment ◽  
Abdominal Ultrasound ◽  
Direct Antiglobulin Test ◽  
Intestinal Neoplasm ◽  
Immune Mediated ◽  
Antiglobulin Test ◽  
Veterinary Hospital

A twelve-year-old male castrated Chihuahua with a severe, microcytic, hypochromic, and nonregenerative direct antiglobulin test positive anemia characterized by marked spherocytosis was referred to the veterinary hospital. Abdominal ultrasound revealed a peritoneal mass of unclear origin. Transfusion, followed by mass resection, rapidly resolved the anemia without further immunosuppressive treatment. Histopathology confirmed extraluminal jejunal leiomyosarcoma. Multiple mechanisms, including immune-mediated destruction, likely contributed to the anemia. To the authors’ knowledge, this is the first report that describes the resolution of immune-mediated hemolysis in a dog after the removal of an intestinal neoplasm.

Tofacitinib for treatment in immune-mediated myocarditis: The first reported cases

2020 ◽  
pp. 107815522094714
Author(s):  
Yun Liu ◽  
Lindi Jiang
Keyword(s):  
Side Effects ◽  
Checkpoint Inhibitors ◽  
Metastatic Cancer ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Immune Mediated ◽  
Ecg Abnormalities ◽  
Effective Treatments

Introduction Immune checkpoint inhibitors (ICI) has demonstrated significant clinical benefit in advanced cancer. Despite favorable benefits, the use of ICI is accompanied by various side effects, which are inflammatory side effects potentially affecting any organ. Among which myocarditis is the most severe and has a relatively high mortality. However, there is no effective treatments, and many patients respond poorly to glucocorticoids and immunosuppressants. Therefore, it is urgent to explore effective treatments. Cases report Here we describe two patients with metastatic cancer who developed immune-mediated myocarditis after receiving anti-programmed cell death protein (PD)-1 antibody. The main clinical manifestations are dyspnea. All patients had an elevation of cardiac enzyme, a variety of atypical electrocardiographic (ECG) abnormalities and preserved left ventricular ejection fraction (LVEF). All our patients underwent cardiac MRI (CMRI) and suggested typical features of myocarditis, including myocardial oedema and delayed enhancement. Management and outcome: All patients were treated promptly with glucocorticoids, followed by other immunosuppressive treatments include plasma exchange and intravenous immunoglobulin (IVIG). However, no significant improvement was observed and we then administered tofacitinib 5 mg twice daily to treat the refractory myocarditis and the elevated levels of pro-inflammatory cytokines. All patients recovered and were discharged. No major adverse reaction was reported during tofacitinib therapy. Discussion To our knowledge, this is the first report in the world of patients with ICI-associated myocarditis treated with oral tofacitinib. Our results can at least provide a new option for clinical treatment of refractory myocarditis or other immune-related adverse events.

Using Naïve Bayes Algorithm to Estimate the Response to Drug in Lung Cancer Patients

2019 ◽  
Vol 21 (10) ◽  
pp. 734-748 ◽  
Author(s):  
Baoling Guo ◽  
Qiuxiang Zheng
Keyword(s):  
Lung Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
Drug Response ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Treatment Strategies ◽  
Cancer Resistance ◽  
Lung Cancer Patients ◽  
Bayes Algorithm

Aim and Objective: Lung cancer is a highly heterogeneous cancer, due to the significant differences in molecular levels, resulting in different clinical manifestations of lung cancer patients there is a big difference. Including disease characterization, drug response, the risk of recurrence, survival, etc. Method: Clinical patients with lung cancer do not have yet particularly effective treatment options, while patients with lung cancer resistance not only delayed the treatment cycle but also caused strong side effects. Therefore, if we can sum up the abnormalities of functional level from the molecular level, we can scientifically and effectively evaluate the patients' sensitivity to treatment and make the personalized treatment strategies to avoid the side effects caused by over-treatment and improve the prognosis. Result & Conclusion: According to the different sensitivities of lung cancer patients to drug response, this study screened out genes that were significantly associated with drug resistance. The bayes model was used to assess patient resistance.

scholarly journals Dual threat of comorbidity of celiac disease and systemic lupus erythematosus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Yimin Ma ◽  
Duanming Zhuang ◽  
Zhenguo Qiao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Celiac Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Severe Malnutrition ◽  
Systemic Lupus ◽  
Electrolyte Disorders ◽  
Diagnostic Challenge ◽  
Immune Mediated

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.

scholarly journals Autoimmune Hemolytic Anemia as a Complication of Congenital Anemias. A Case Series and Review of the Literature

2021 ◽  
Vol 10 (15) ◽  
pp. 3439
Author(s):  
Irene Motta ◽  
Juri Giannotta ◽  
Marta Ferraresi ◽  
Kordelia Barbullushi ◽  
Nicoletta Revelli ◽  
...  
Keyword(s):  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Case Series ◽  
Intravenous Immunoglobulins ◽  
Point Of View ◽  
First Line ◽  
Human Erythropoietin ◽  
Immune Mediated ◽  
Hemolytic Crisis ◽  
Life Threatening

Congenital anemias may be complicated by immune-mediated hemolytic crisis. Alloantibodies are usually seen in chronically transfused patients, and autoantibodies have also been described, although they are rarely associated with overt autoimmune hemolytic anemia (AIHA), a serious and potentially life-threatening complication. Given the lack of data on the AIHA diagnosis and management in congenital anemias, we retrospectively evaluated all clinically relevant AIHA cases occurring at a referral center for AIHA, hemoglobinopathies, and chronic hemolytic anemias, focusing on clinical management and outcome. In our cohort, AIHA had a prevalence of 1% (14/1410 patients). The majority were warm AIHA. Possible triggers were recent transfusion, infection, pregnancy, and surgery. All the patients received steroid therapy as the first line, and about 25% required further treatment, including rituximab, azathioprine, intravenous immunoglobulins, and cyclophosphamide. Transfusion support was required in 57% of the patients with non-transfusion-dependent anemia, and recombinant human erythropoietin was safely administered in one third of the patients. AIHA in congenital anemias may be challenging both from a diagnostic and a therapeutic point of view. A proper evaluation of hemolytic markers, bone marrow compensation, and assessment of the direct antiglobulin test is mandatory.

Bilateral dysthyroid compressive optic neuropathy responsive to teprotumumab

2021 ◽  
pp. 112067212199104
Author(s):  
Catherine J Hwang ◽  
Erin E Nichols ◽  
Brian H Chon ◽  
Julian D Perry
Keyword(s):  
Side Effects ◽  
Optic Neuropathy ◽  
Surgical Decompression ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
High Dose ◽  
Compressive Optic Neuropathy ◽  
Traditional Management ◽  
Immune Mediated ◽  
Orbital Radiation

Thyroid eye disease is an auto-immune mediated orbitopathy which can cause dysthyroid compressive optic neuropathy. Traditional management of active thyroid eye disease includes temporizing high-dose steroids, orbital radiation and surgical decompression, which each possess significant limitations and/or side effects. Teprotumumab is an IGF-IR inhibitor recently FDA-approved for active thyroid eye disease. The authors report reversal of bilateral dysthyroid compressive optic neuropathy managed medically utilizing teprotumumab.

scholarly journals Inflammatory Skin Lesions in Three SARS-CoV-2 Swab-Negative Adolescents: A Possible COVID-19 Sneaky Manifestation?

2021 ◽  
Vol 13 (2) ◽  
pp. 181-188
Author(s):  
Giuseppe Ingravallo ◽  
Francesco Mazzotta ◽  
Leonardo Resta ◽  
Sara Sablone ◽  
Gerardo Cazzato ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Respiratory Symptoms ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Sweat Glands ◽  
Histological Findings ◽  
Immune Mediated ◽  
Nodular Lesions ◽  
Immunohistochemical Evidence ◽  
Eccrine Sweat Glands

Coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with various clinical manifestations, including skin lesions. In particular, during the COVID-19 pandemic lock-down period numerous chilblain-like lesions, mainly located on the feet, were observed in adolescents. The latter were often asymptomatic or associated with very mild respiratory symptoms. Here, we report three cases of acral nodular lesions in SARS-CoV-2 swab-negative adolescents with histological findings of chronic immune-mediated inflammation and immunohistochemical evidence of SARS-CoV-2 spike glycoproteins in endothelial cells and eccrine sweat glands. In one of these cases, the virus presence was confirmed by electron microscopy.

scholarly journals Cold Agglutinin-Mediated Autoimmune Hemolytic Anemia in Association with Antiphospholipid Syndrome

2021 ◽  
pp. 1-4
Author(s):  
Ram Gelman ◽  
Fadi Kharouf ◽  
Yuval Ishay ◽  
Alexander Gural
Keyword(s):  
Hemolytic Anemia ◽  
Antiphospholipid Syndrome ◽  
Complement Activation ◽  
Autoimmune Hemolytic Anemia ◽  
Cold Agglutinin ◽  
Primary Antiphospholipid Syndrome ◽  
Unique Case ◽  
Hematologic Disorders ◽  
Clear Association ◽  
Immune Mediated

Antiphospholipid syndrome and cold agglutinin-mediated autoimmune hemolytic anemia are 2 distinct immune-mediated hematologic disorders. While no clear association exists between these 2 entities, complement activation is known to occur in both of them. Herein, we report a unique case of cold agglutinin hemolytic anemia in a patient with a known primary antiphospholipid syndrome.

Treatment of Heparin-Induced Thrombocytopenia

2002 ◽  
Vol 36 (3) ◽  
pp. 489-503 ◽  
Author(s):  
William E Dager ◽  
Richard H White
Keyword(s):  
Adverse Reaction ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Low Molecular Weight ◽  
National Library ◽  
Severe Adverse Reaction ◽  
Heparin Induced Thrombocytopenia ◽  
Immune Mediated ◽  
Study Selection ◽  
Clinical Conditions

OBJECTIVE: To describe heparin-induced thrombocytopenia (HIT or HIT-2), an immune-mediated adverse reaction to heparin or low-molecular-weight heparin. Available treatment options and considerations in developing a therapy approach are discussed. DATA SOURCES: A search of the National Library of Medicine (1992–June 2001) was done to identify pertinent literature. Additional references were reviewed from selected articles. STUDY SELECTION: Articles related to laboratory recognition and treatment options of HIT, including the use of agents in selected clinical conditions, were reviewed and included. CONCLUSIONS: HIT is a rare but potentially severe adverse reaction to heparin that was, until recently, poorly understood and had limited treatment options. Recent advances describing the recognition and clinical manifestations of immune-mediated HIT, including recently available antithrombotic treatment options, have dramatically changed outcomes for patients having this syndrome.

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