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141.
142.
143.
Autoimmune hemolytic anemia in Kawasaki disease: a case report 总被引:1,自引:0,他引:1
A 3-year-old boy presented with the fever, conjunctivitis, rash, and lymphadenopathy diagnostic of Kawasaki disease. Treatment with antibiotics, aspirin, and intravenous immunoglobulin was instituted. The hematocrit decreased from 35 percent on admission to 11 percent by hospital Day 10, and the white cell count had increased from 13.7 to 42 × 10(3) per microL, and the patient had a leukoerythroblastic blood smear. The direct antiglobulin test demonstrated IgG but not complement on the red cell (RBC) surface. An acid eluate reacted (titer of 4) with all panel cells in the antiglobulin phase. Intravenous immunoglobulin from the same lot used for treatment did not contain antibody that reacted with the patient's group O RBCs or a panel of group O RBCs, but did contain IgG anti-A and -B (titer of 4). The patient received a transfusion and was given methylprednisone. The direct antiglobulin test and acid eluate were negative 4 days later. The patient had an uneventful recovery. The distinction between antibody-mediated hemolytic anemia and autoimmune hemolytic anemia is important in the treatment of this disease. 相似文献
144.
A concentrate of mononuclear bone marrow cells is often desired for ex vivo treatment with pharmacologic agents, monoclonal antibodies, cytokines, and other agents prior to transplantation. A method has been developed for automated separation of mononuclear cells from large volumes of harvested bone marrow. A programmable instrument originally designed for clinical ex vivo cell separation and the plasma-pheresis of patients and blood donors was adapted to permit rapid preparation, in a closed sterile system, of a bone marrow product enriched with mononuclear cells. A mean (+/- SEM) of 53 +/- 30 percent of the original mononuclear cells was recovered in a volume of 125 +/- 42 mL containing 82 +/- 12 percent mononuclear cells. This technique removed 95 +/- 9 percent of the red cells in the original marrow. No density gradient materials or sedimenting agents were employed in this process. Of 36 marrows processed by this technique, 19 autologous (6 of which were purged with 4-hydroperoxycyclophosphamide) and 7 allogeneic marrows have been transplanted, with all evaluable patients achieving a neutrophil count of 0.5 x 10(9) per L in a mean (+/- SEM) of 21 +/- 6 days. 相似文献
145.
Patients who develop inflammatory polyarthritis (IP) after immunization are clinically indistinguishable from other patients with IP 总被引:2,自引:1,他引:2
Harrison BJ; Thomson W; Pepper L; Ollier WE; Chakravarty K; Barrett EM; Silman AJ; Symmons DP 《Rheumatology (Oxford, England)》1997,36(3):366-369
Musculoskeletal symptoms may occur following various types of immunization,
and it has also been suggested that, like infection, immunization may act
as a trigger for rheumatoid arthritis (RA). A total of 48 of 898 (5.3%)
patients with early inflammatory polyarthritis (IP) referred to the Norfolk
Arthritis Register reported an immunization in the 6 weeks prior to symptom
onset. There were no important clinical or demographic differences between
the 48 immunized patients and 185 consecutive patients who did not report
prior immunization. In addition, the frequencies of HLA-DRB1*01. *04 and
the shared epitope in 33 of the immunized patients were similar to those in
the 185 non-immunized patients and to those in 136 healthy controls.
Further results from a case-control study suggest that the rate of
immunization is higher amongst cases (5.5%) than age- and sex-matched
controls (2.8%). In a small number of susceptible individuals, immunization
may thus act as a trigger for RA.
相似文献
146.
Murine hematopoietic cells can be transformed in vitro by recombinant retroviruses that express the myb oncogene, and hematopoietic growth factor (HGF)-dependent myeloid cell lines can be derived from these transformed primary cells. In this study, the differentiation state and responses of myb-transformed hematopoietic cells (MTHCs) have been investigated. We find that MTHCs exhibit properties of early myeloid progenitors including synergistic responses to combinations of HGFs and expression of certain surface markers. As reported previously, MTHCs respond well to granulocyte-macrophage colony-stimulating factor (GM- CSF) but can also respond to interleukin-3 (IL-3); the response to the latter factor depends on the mouse strain from which the cells are derived. Although these single factors stimulate MTHCs, combinations of these factors with colony-stimulating factor-1 (CSF-1 or M-CSF) or Steel factor (SLF or SCF) act synergistically to promote colony formation. The surface markers expressed by MTHCs include both granulocyte-macrophage lineage specific antigens Gr-1, 7/4, F4/80, and Mac-1, as well as two antigens found on early progenitors and stem cells--Thy-1 and Sca-1 (Ly6E). Expression of the latter markers is often heterogeneous and can be modulated by the growth factors to which the cells are exposed. Finally, we show that monocytic differentiation of MTHCs can be induced by exposure to tumor necrosis factor (TNF alpha). Taken together, these results suggest that MTHCs will be a useful model for studying HGF/cytokine responses in both proliferation and differentiation. 相似文献
147.
Histologic liver abnormalities in an autopsy series of patients with rheumatoid arthritis 总被引:1,自引:1,他引:1
Ruderman EM; Crawford JM; Maier A; Liu JJ; Gravallese EM; Weinblatt ME 《Rheumatology (Oxford, England)》1997,36(2):210-213
A retrospective review was performed on 188 autopsied cases of rheumatoid
arthritis at our institutions during 1958-1985, prior to the widespread use
of methotrexate. Hepatic histology was reported in 182 cases. All available
microscopic liver slides from cases in which the autopsy report described
portal tract inflammation, fibrosis, cirrhosis, tumour, amyloid,
vasculitis, or infections involving the liver were examined and graded by a
hepatic pathologist blinded to the original diagnosis, along with a
representative sample of cases with reports describing fatty change or no
hepatic pathologic abnormalities. Ninety normal and abnormal cases were
reviewed from the 182 for which hepatic histology was available. Fifteen
cases of diffuse fibrosis were identified upon blinded review. Two cases
were graded as severe fibrosis (grades 3 or 4 on a scale of 0-4) without an
identifiable pathologic cause, in both of which the liver disease was
suspected premortem (alcohol abuse and viral hepatitis). Although the
incidence of fibrosis in this series is slightly higher than that
previously described, serious fibrotic liver disease was rare. These
results support the current practice of limiting pre-treatment liver
biopsies prior to methotrexate therapy to patients with suspected liver
disease.
相似文献
148.
Bernstein ZP; Porter MM; Gould M; Lipman B; Bluman EM; Stewart CC; Hewitt RG; Fyfe G; Poiesz B; Caligiuri MA 《Blood》1995,86(9):3287-3294
Ten adult patients with human immunodeficiency virus (HIV)-associated malignancies (five with lymphoma and five with Kaposi's Sarcoma) were treated with a daily subcutaneous injection of interleukin-2 (IL-2) for 90 consecutive days in a phase I dose-escalation study. Seven patients had absolute CD4 counts below 200/mm3 at the time malignancy was diagnosed. Each lymphoma patient had obtained a complete or partial remission with standard chemotherapy before initiating IL-2. The daily dose of IL-2 did not change during the 90-day course of therapy. Seventeen courses of IL-2 therapy were completed at doses ranging from 0.4 x 10(6) U/m2/d to 1.2 x 10(6) U/m2/d without significant (grade III) toxicity. Two of two patients experienced grade III toxicity within 21 days of initiating IL-2 at a dose of 1.4 x 10(6) U/m2/d, but both patients subsequently completed 90 days of therapy at the maximum tolerated dose (MTD) of 1.2 x 10(6) U/m2/d. Although there were no significant increases or decreases in T-cell subsets at any dose level, there was an increase in absolute natural killer (NK) cell number at the three highest doses of IL-2 (mean percent increase 247; 95% confidence interval, 124 to 369) that was statistically significant (Wilcoxon one-sample signed rank test, P = .015). One patient developed an anti-IL-2 antibody titer that correlated with minimal NK cell expansion in vitro and in vivo. An increase in eosinophils was noted during 9 of 17 courses of IL-2 therapy without correlation to IL-2 dose, prior course of IL-2, or NK cell expansion. At the MTD, there was no consistent increase in the plasma HIV RNA level over time. Three of 10 patients had progressive disease while on study. During 50 months of IL-2 therapy, no patient was treated for an opportunistic infection. We conclude that daily low dose subcutaneous IL-2 can be self-administered safely with good compliance for prolonged periods of time to patients with HIV-associated malignancies, including those with profound immune deficiency. The majority of patients show selective expansion of innate immune effectors, ie, NK cells and/or eosinophils, in the absence of significant clinical toxicity or increased viral burden. These results suggest that low-dose IL-2 therapy should be studied further in phase II clinical trials for evidence of activity against malignancy and opportunistic infection in this patient population. 相似文献
149.
Reticulocyte size in nutritional anemias 总被引:2,自引:0,他引:2
Alterations in reticulocyte size occur 2-3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2-3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size. 相似文献
150.
Wolfgang Kratzer Beate Gruener Tanja EM Kaltenbach Sarina Ansari-Bitzenberger Peter Kern Michael Fuchs Richard A Mason Thomas FE Barth Mark M Haenle Andreas Hillenbrand Suemeyra Oeztuerk Tilmann Graeter 《World journal of gastroenterology : WJG》2015,21(43):12392-12402
AIM: To establish an ultrasonographic classification based on a large sample of patients with confirmed hepatic alveolar echinococcosis(AE).METHODS: Clinical data and ultrasonography(US) findings of 185 patients(100 males; 85 females; mean age at diagnosis: 51.4 ± 17.6 years; mean age at time of US examination: 58.7 ± 18.2 years) were retrospectively reviewed with respect to the US morphology of hepatic AE lesions. The sonomorphological findings were grouped according to a five-part classification scheme.RESULTS: Application of the new classification resulted in the following distribution of sonomorphological patterns among the patients examined: hailstorm(54.1%); pseudocystic(13.5%); ossification(13.0%); hemangioma-like(8.1%); and metastasis-like(6.5%). Only 4.9% of lesions could not be assigned to a sonomorphological pattern.CONCLUSION: The sonomorphological classification proposed in the present study facilitates the diagnosis,interpretation and comparison of hepatic alveolar echinococcosis in routine practice and in the context of scientific studies. 相似文献