Objective:To present platelet large cell ratio(P-LCR),reticulocyte,and immature reticulocyte fraction(IRF)values as novel parameters in diagnosis and response to treatment in patients developing sacroiliitis.Methods:S...Objective:To present platelet large cell ratio(P-LCR),reticulocyte,and immature reticulocyte fraction(IRF)values as novel parameters in diagnosis and response to treatment in patients developing sacroiliitis.Methods:Sixty-eight patients with clinical symptoms and Brucella standard tube agglutination(Wright)or Brucella Coombs agglutination test titers≥1:160 were included in the study.Two groups were established,one developing sacroiliitis and another with no sacroiliitis development.P-LCR,reticulocyte,and IRF levels were measured using a Sysmex XN-9000 device(Japan).These were then compared between the two groups.Results:Reticulocyte(P=0.037)and IRF(P=0.026)levels were significantly lower among the patients developing sacroiliitis compared to the non-sacroiliitis group,while P-LCR(P=0.003)levels were significantly higher.P-LCR had the most powerful correlation with sacroiliitis development.Significant negative correlation was observed between reticulocyte,IRF levels and sacroiliitis.Conclusions:Elevated P-LCR levels were observed as a marker of persisting inflammation in patients developing sacroiliitis,while low reticulocyte and IRF levels secondary to bone marrow involvement were detected.These three parameters emerged as highly significant markers in terms of diagnosis and reflecting responses to treatment in organ involvement such as sacroiliitis in brucellosis.These are presented as inexpensive,and easily accessible novel parameters.展开更多
BACKGROUND Multiple endocrine neoplasia type 2(MEN2)is a rare,autosomal dominant endocrine disease.Currently,the RET proto-oncogene is the only gene implicated in MEN2A pathogenesis.Once an RET carrier is detected,fam...BACKGROUND Multiple endocrine neoplasia type 2(MEN2)is a rare,autosomal dominant endocrine disease.Currently,the RET proto-oncogene is the only gene implicated in MEN2A pathogenesis.Once an RET carrier is detected,family members should be screened to enable early detection of medullary thyroid carcinoma,pheochromocytoma,and hyperparatitity.Among these,medullary thyroid carcinoma is the main factor responsible for patient mortality.Accordingly,delineating strategies to inform clinical follow-up and treatment plans based on genes is paramount for clinical practitioners.CASE SUMMARY Herein,we present RET proto-oncogene mutations,clinical characteristics,and treatment strategies in a family with MEN2A.A family study was conducted on patients diagnosed with MEN2A.DNA was extracted from the peripheral blood of family members,and first-generation exon sequencing of the RET protooncogene was conducted.The C634Y mutation was identified in three family members spanning three generations.Two patients were sequentially diagnosed with pheochromocytomas and bilateral medullary thyroid carcinomas.A 9-yearold child harboring the gene mutation was diagnosed with medullary thyroid carcinoma.Surgical resection of the tumors was performed.All family members were advised to undergo complete genetic testing related to the C634Y mutation,and the corresponding treatments administered based on test results and associated clinical guidelines.CONCLUSION Advancements in MEN2A research are important for familial management,assessment of medullary thyroid cancer invasive risk,and deciding surgical timing.展开更多
<strong>Background:</strong> Diagnosis of iron deficiency anemia with currently available tests is rendered difficult in hemodialysis patients. <strong>The aim:</strong> To investigate the role...<strong>Background:</strong> Diagnosis of iron deficiency anemia with currently available tests is rendered difficult in hemodialysis patients. <strong>The aim:</strong> To investigate the role of reticulocyte Hemoglobin Content (CHr) in the diagnosis of iron deficiency anemia in hemodialysis children in comparison to the used traditional markers and assess the impressiveness and the utility of Neutrophil Gelatinase Associated Lipocalin (NGAL) as a novel biomarker of iron status in those patients. <strong>Methods:</strong> This study investigated CHr in addition to NGAL serum level in the same line with traditional markers for anemia, including: CBC, serum iron, ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT%). <strong>Results:</strong> It is more significant that CHr content in hemodialysis children is lower than their controls as they are (27.06 ± 2.90) pg and (32.86 ± 3.59) pg, respectively, p = 0.01. There is no significant difference regarding NGAL between the study groups. Significant negative correlation between CHr with ferritin, urea, creatinine, and positively correlated with iron and RBCS. CHr showed a sensitivity of 90% and specificity of 86.67% to detect iron-deficiency anemia with a cut-off value of 27 pg. <strong>Conclusion:</strong> CHr is superior to ferritin and TSAT % for the early diagnosis of iron deficiency anemia in hemodialysis children;our results do not support NGAL as a marker of anemia in hemodialysis patients.展开更多
Introduction: Central serous chorioretinopathy (CSCR) is associated with serous sensorineural retinal detachment in the macular region. The condition that affects the male gender more than their female counterpart res...Introduction: Central serous chorioretinopathy (CSCR) is associated with serous sensorineural retinal detachment in the macular region. The condition that affects the male gender more than their female counterpart results from focal leakage disturbance of retinal pigment epithelial cells and choroidal abnormalities. The corticosteroid is highlighted as one of the major factors that promote the occurrence of CSCR. Stress and pregnancy, especially in the third trimester, have also been reported by some authors. Central serous chorioretinopathy associated with pregnancy complicated by retroplacental hematoma is a rare event. Observation: We report the case of a pregnant woman at approximately 34 weeks of amenorrhea who presented a sudden and severe drop in visual acuity on a pregnancy complicated by retroplacental hematoma and delivered by cesarean section. The diagnosis was based on clinical arguments associated with photos of the retina made by the MII Ret Cam device (Made In India, Retinoscope Camera) highlighting the lifting of the macular region. Ophthalmological monitoring without medical or physical treatment was instituted. At two months of progression without treatment, bilateral visual acuity was 10/10. Conclusion: Central serous chorioretinopathy and pregnancy is not unusual;however, its bilateral and brutal form in a context of pregnancy complicated by retroplacental hematoma is rare. Despite this favorable evolution, monitoring remains necessary in order to prevent recurrences and complications.展开更多
文摘Objective:To present platelet large cell ratio(P-LCR),reticulocyte,and immature reticulocyte fraction(IRF)values as novel parameters in diagnosis and response to treatment in patients developing sacroiliitis.Methods:Sixty-eight patients with clinical symptoms and Brucella standard tube agglutination(Wright)or Brucella Coombs agglutination test titers≥1:160 were included in the study.Two groups were established,one developing sacroiliitis and another with no sacroiliitis development.P-LCR,reticulocyte,and IRF levels were measured using a Sysmex XN-9000 device(Japan).These were then compared between the two groups.Results:Reticulocyte(P=0.037)and IRF(P=0.026)levels were significantly lower among the patients developing sacroiliitis compared to the non-sacroiliitis group,while P-LCR(P=0.003)levels were significantly higher.P-LCR had the most powerful correlation with sacroiliitis development.Significant negative correlation was observed between reticulocyte,IRF levels and sacroiliitis.Conclusions:Elevated P-LCR levels were observed as a marker of persisting inflammation in patients developing sacroiliitis,while low reticulocyte and IRF levels secondary to bone marrow involvement were detected.These three parameters emerged as highly significant markers in terms of diagnosis and reflecting responses to treatment in organ involvement such as sacroiliitis in brucellosis.These are presented as inexpensive,and easily accessible novel parameters.
基金Supported by The Finance Bureau of Dongguan City,Guangdong Province.
文摘BACKGROUND Multiple endocrine neoplasia type 2(MEN2)is a rare,autosomal dominant endocrine disease.Currently,the RET proto-oncogene is the only gene implicated in MEN2A pathogenesis.Once an RET carrier is detected,family members should be screened to enable early detection of medullary thyroid carcinoma,pheochromocytoma,and hyperparatitity.Among these,medullary thyroid carcinoma is the main factor responsible for patient mortality.Accordingly,delineating strategies to inform clinical follow-up and treatment plans based on genes is paramount for clinical practitioners.CASE SUMMARY Herein,we present RET proto-oncogene mutations,clinical characteristics,and treatment strategies in a family with MEN2A.A family study was conducted on patients diagnosed with MEN2A.DNA was extracted from the peripheral blood of family members,and first-generation exon sequencing of the RET protooncogene was conducted.The C634Y mutation was identified in three family members spanning three generations.Two patients were sequentially diagnosed with pheochromocytomas and bilateral medullary thyroid carcinomas.A 9-yearold child harboring the gene mutation was diagnosed with medullary thyroid carcinoma.Surgical resection of the tumors was performed.All family members were advised to undergo complete genetic testing related to the C634Y mutation,and the corresponding treatments administered based on test results and associated clinical guidelines.CONCLUSION Advancements in MEN2A research are important for familial management,assessment of medullary thyroid cancer invasive risk,and deciding surgical timing.
文摘<strong>Background:</strong> Diagnosis of iron deficiency anemia with currently available tests is rendered difficult in hemodialysis patients. <strong>The aim:</strong> To investigate the role of reticulocyte Hemoglobin Content (CHr) in the diagnosis of iron deficiency anemia in hemodialysis children in comparison to the used traditional markers and assess the impressiveness and the utility of Neutrophil Gelatinase Associated Lipocalin (NGAL) as a novel biomarker of iron status in those patients. <strong>Methods:</strong> This study investigated CHr in addition to NGAL serum level in the same line with traditional markers for anemia, including: CBC, serum iron, ferritin, total iron-binding capacity (TIBC), and transferrin saturation (TSAT%). <strong>Results:</strong> It is more significant that CHr content in hemodialysis children is lower than their controls as they are (27.06 ± 2.90) pg and (32.86 ± 3.59) pg, respectively, p = 0.01. There is no significant difference regarding NGAL between the study groups. Significant negative correlation between CHr with ferritin, urea, creatinine, and positively correlated with iron and RBCS. CHr showed a sensitivity of 90% and specificity of 86.67% to detect iron-deficiency anemia with a cut-off value of 27 pg. <strong>Conclusion:</strong> CHr is superior to ferritin and TSAT % for the early diagnosis of iron deficiency anemia in hemodialysis children;our results do not support NGAL as a marker of anemia in hemodialysis patients.
文摘Introduction: Central serous chorioretinopathy (CSCR) is associated with serous sensorineural retinal detachment in the macular region. The condition that affects the male gender more than their female counterpart results from focal leakage disturbance of retinal pigment epithelial cells and choroidal abnormalities. The corticosteroid is highlighted as one of the major factors that promote the occurrence of CSCR. Stress and pregnancy, especially in the third trimester, have also been reported by some authors. Central serous chorioretinopathy associated with pregnancy complicated by retroplacental hematoma is a rare event. Observation: We report the case of a pregnant woman at approximately 34 weeks of amenorrhea who presented a sudden and severe drop in visual acuity on a pregnancy complicated by retroplacental hematoma and delivered by cesarean section. The diagnosis was based on clinical arguments associated with photos of the retina made by the MII Ret Cam device (Made In India, Retinoscope Camera) highlighting the lifting of the macular region. Ophthalmological monitoring without medical or physical treatment was instituted. At two months of progression without treatment, bilateral visual acuity was 10/10. Conclusion: Central serous chorioretinopathy and pregnancy is not unusual;however, its bilateral and brutal form in a context of pregnancy complicated by retroplacental hematoma is rare. Despite this favorable evolution, monitoring remains necessary in order to prevent recurrences and complications.