BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system dis...BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system diseases,presenting atypical symptoms.Very few brucellosis cases with pancytopenia accompanied by a severe hearing loss have been reported.In the literature review,we could find only one similar case reported in the past.Moreover,this disease is easily misdiagnosed as a blood system disease leading to delayed treatment.Thus,it is important to improve clinicians'awareness of this disease.CASE SUMMARY A 64-year-old woman presented with dizziness and fatigue,accompanied by pancytopenia and severe hearing loss.Brucella melitensis was identified on blood culture.Anti-infective therapy with rifampicin(900 mg/d)and doxycycline(100 mg twice a day)was prescribed for 4 mo along with ceftriaxone 2 g/d for 1 mo.The patient showed a good response to antibiotic therapy.Her blood counts returned to normal followed by significant improvement in hearing.CONCLUSION Brucellosis should be considered in the differential diagnosis of patients presenting with pancytopenia and hearing loss.展开更多
Background: Hematopoietic system is seriously affected by tuberculosis. It exerts a dazzling variety of hematological effects involving both cell lines and plasma components [1]. Anemia and leukopenia are not unusual ...Background: Hematopoietic system is seriously affected by tuberculosis. It exerts a dazzling variety of hematological effects involving both cell lines and plasma components [1]. Anemia and leukopenia are not unusual with tuberculosis (TB), but pancytopenia is rare [2]. Findings: In this report, we described a case of a 42 years man presenting bleeding and pancytopenia;bacteriological pulmonary TB was established by genotypic rapid test and treatment following the WHO guidelines on drug-sensitive TB treatment. Patient recovered entirely with the WHO recommended regimen associated with general and local treatment of the bleeding. Conclusion: This case report emphasizes the importance of always suspecting tuberculosis in a tuberculosis-endemic area, even when the clinical manifestations are atypical, like pancytopenia and also of properly investigating the differential diagnosis. Even though prognosis seems to be less good, actual treatment regimen is still effective.展开更多
BACKGROUND Typhoid fever is a public health problem in Asia and Africa.Pancytopenia has been rarely reported during the 20th century.Reports during the last 20 years are scarce.CASE SUMMARY Our first patient was a you...BACKGROUND Typhoid fever is a public health problem in Asia and Africa.Pancytopenia has been rarely reported during the 20th century.Reports during the last 20 years are scarce.CASE SUMMARY Our first patient was a young adult male presenting with febrile neutropenia whose blood and bone marrow cultures grew Salmonella typhi.He recovered before discharge from the hospital.The second was a primigravida who had an abortion following a febrile illness and was found to have pancytopenia.The Widal test showed high initial titers,and she was presumptively treated for typhoid.Convalescence showed a doubling of Widal titers.CONCLUSION Typhoid fever continued to show up as a fever with cytopenia demanding significant effort and time in working up such patients.In developing countries,the liaison with typhoid continues.展开更多
Background: Pancytopenia is a common hematological parameter detected in Hematology department. It is important to find out the etiology of pancytopenia for the better management of patient. Pancytopenia represents a ...Background: Pancytopenia is a common hematological parameter detected in Hematology department. It is important to find out the etiology of pancytopenia for the better management of patient. Pancytopenia represents a wide range of age groups and most pancytopenia is purely of bone marrow dysfunction origin. However, other causes such as hypersplenism and SLE are also frequently encountered. Objectives: To differentiate various causes of pancytopenia, to evaluate the hematological parameters in pancytopenic cases, and to analyze clinical manifestations in cases of pancytopenia. Materials and Methods: There were 25 admitted cases of pancytopenia at Affiliated Hospital of Dali University between the calendar year 2013 and 2014. A detail study was done on the basis of age, gender, clinical features, typical laboratory investigations, bone marrow examination, and final diagnosis. Results and Conclusions: Among 25 cases studied, megaloblastic anemia was the common cause of pancytopenia and incidence of megaloblastic anemia was higher in males after 5th decade of life. Pancytopenic cases age was ranging from 15 to 80 years. Fatigue and dizziness were the most common clinical features presented.展开更多
Objective To measure the quantities and apoptosis-related protein levels of B lymphocyte in the patients with immunorelated pancytopenia(IRP)and explore the action of B lymphocyte in the pathogenic mechanism of IRP. M...Objective To measure the quantities and apoptosis-related protein levels of B lymphocyte in the patients with immunorelated pancytopenia(IRP)and explore the action of B lymphocyte in the pathogenic mechanism of IRP. Methods Quantities of whole B lymphocytes and CD5+ B lymphocytes as well as the expressions of Fas and Bcl-2 in B lymphocytes in 35 patients with untreated IRP, 15 IRP patients in complete remission (CR), and 10 normal controls were assayed by flow cytometry. Results The percentages of B lymphocyte and CD5+ B lymphocyte were significantly higher in untreated IRP patients than in CR IRP patients and normal controls (P<0.05), and there was no significant difference between the latter two groups (P>0.05). There was no significant difference of Fas expression in B lymphocyte among three groups (P>0.05). The expression of Bcl-2 in B lymphocyte was significantly higher in untreated patients than in CR patients or normal controls (P<0.01), and significantly higher in CR patients than in normal controls (P<0.01). The apoptosis-related index was significantly lower in untreated patients than in CR patients or normal controls (P<0.05), and significantly lower in CR patients than in normal controls (P<0.05). The percentage of B lymphocyte was positively correlated with post-treated response time(r=0.53, P<0.01). Conclusion The production of auto-antibodies in IRP patients probably has some relationship with the abnormal quantities of B lymphocyte and its subpopulations as well as with the inhibition of B lymphocyte apoptosis.展开更多
Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease...Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease. We report a 15-year-old boy presented with fever, dry cough and dyspnea from two months ago, after admission patient had nodular lesions on the left leg and hepatosplenomegaly. Then he manifested neurologic signs such as seizure, aphasia and right-sided hemiplegia. Chest X-ray and CT scan revealed bilateral pulmonary nodules predominantly in lower lobes and peripheral lung fields. Laboratory exams showed pancytopenia. Skin biopsy was done, and histopathological examination and immunohistochemistry evaluation confirmed lymphomatoid granulomatosis. He was treated with steroid and cyclophosphamide but succumbed by neurologic involvement.展开更多
The protocol and evaluation of I therapy have already been established, and it is quite effective in general for patients with metastatic thyroid cancer under 40 years old with fine or occult type of pulmonary metasta...The protocol and evaluation of I therapy have already been established, and it is quite effective in general for patients with metastatic thyroid cancer under 40 years old with fine or occult type of pulmonary metastases (papillary adenocarcinoma). However, the response of bone metastasis to I therapy is limited to only a part of tumors and is temporary in most cases although high I accumulation is visualized on scintigram. We have encountered a 65-year-old man with thyroid cancer. At the age of 61, follicular thyroid cancer with multiple bone metastasis was diagnosed, total thyroidectomy was carried out, and subsequently I therapy was performed. Bone pain diminished展开更多
文摘BACKGROUND Brucellosis is one of the most common zoonotic infectious diseases in the world,with approximately 500000 new cases of human brucellosis diagnosed each year.Brucellosis can simulate various multi-system diseases,presenting atypical symptoms.Very few brucellosis cases with pancytopenia accompanied by a severe hearing loss have been reported.In the literature review,we could find only one similar case reported in the past.Moreover,this disease is easily misdiagnosed as a blood system disease leading to delayed treatment.Thus,it is important to improve clinicians'awareness of this disease.CASE SUMMARY A 64-year-old woman presented with dizziness and fatigue,accompanied by pancytopenia and severe hearing loss.Brucella melitensis was identified on blood culture.Anti-infective therapy with rifampicin(900 mg/d)and doxycycline(100 mg twice a day)was prescribed for 4 mo along with ceftriaxone 2 g/d for 1 mo.The patient showed a good response to antibiotic therapy.Her blood counts returned to normal followed by significant improvement in hearing.CONCLUSION Brucellosis should be considered in the differential diagnosis of patients presenting with pancytopenia and hearing loss.
文摘Background: Hematopoietic system is seriously affected by tuberculosis. It exerts a dazzling variety of hematological effects involving both cell lines and plasma components [1]. Anemia and leukopenia are not unusual with tuberculosis (TB), but pancytopenia is rare [2]. Findings: In this report, we described a case of a 42 years man presenting bleeding and pancytopenia;bacteriological pulmonary TB was established by genotypic rapid test and treatment following the WHO guidelines on drug-sensitive TB treatment. Patient recovered entirely with the WHO recommended regimen associated with general and local treatment of the bleeding. Conclusion: This case report emphasizes the importance of always suspecting tuberculosis in a tuberculosis-endemic area, even when the clinical manifestations are atypical, like pancytopenia and also of properly investigating the differential diagnosis. Even though prognosis seems to be less good, actual treatment regimen is still effective.
文摘BACKGROUND Typhoid fever is a public health problem in Asia and Africa.Pancytopenia has been rarely reported during the 20th century.Reports during the last 20 years are scarce.CASE SUMMARY Our first patient was a young adult male presenting with febrile neutropenia whose blood and bone marrow cultures grew Salmonella typhi.He recovered before discharge from the hospital.The second was a primigravida who had an abortion following a febrile illness and was found to have pancytopenia.The Widal test showed high initial titers,and she was presumptively treated for typhoid.Convalescence showed a doubling of Widal titers.CONCLUSION Typhoid fever continued to show up as a fever with cytopenia demanding significant effort and time in working up such patients.In developing countries,the liaison with typhoid continues.
文摘Background: Pancytopenia is a common hematological parameter detected in Hematology department. It is important to find out the etiology of pancytopenia for the better management of patient. Pancytopenia represents a wide range of age groups and most pancytopenia is purely of bone marrow dysfunction origin. However, other causes such as hypersplenism and SLE are also frequently encountered. Objectives: To differentiate various causes of pancytopenia, to evaluate the hematological parameters in pancytopenic cases, and to analyze clinical manifestations in cases of pancytopenia. Materials and Methods: There were 25 admitted cases of pancytopenia at Affiliated Hospital of Dali University between the calendar year 2013 and 2014. A detail study was done on the basis of age, gender, clinical features, typical laboratory investigations, bone marrow examination, and final diagnosis. Results and Conclusions: Among 25 cases studied, megaloblastic anemia was the common cause of pancytopenia and incidence of megaloblastic anemia was higher in males after 5th decade of life. Pancytopenic cases age was ranging from 15 to 80 years. Fatigue and dizziness were the most common clinical features presented.
文摘Objective To measure the quantities and apoptosis-related protein levels of B lymphocyte in the patients with immunorelated pancytopenia(IRP)and explore the action of B lymphocyte in the pathogenic mechanism of IRP. Methods Quantities of whole B lymphocytes and CD5+ B lymphocytes as well as the expressions of Fas and Bcl-2 in B lymphocytes in 35 patients with untreated IRP, 15 IRP patients in complete remission (CR), and 10 normal controls were assayed by flow cytometry. Results The percentages of B lymphocyte and CD5+ B lymphocyte were significantly higher in untreated IRP patients than in CR IRP patients and normal controls (P<0.05), and there was no significant difference between the latter two groups (P>0.05). There was no significant difference of Fas expression in B lymphocyte among three groups (P>0.05). The expression of Bcl-2 in B lymphocyte was significantly higher in untreated patients than in CR patients or normal controls (P<0.01), and significantly higher in CR patients than in normal controls (P<0.01). The apoptosis-related index was significantly lower in untreated patients than in CR patients or normal controls (P<0.05), and significantly lower in CR patients than in normal controls (P<0.05). The percentage of B lymphocyte was positively correlated with post-treated response time(r=0.53, P<0.01). Conclusion The production of auto-antibodies in IRP patients probably has some relationship with the abnormal quantities of B lymphocyte and its subpopulations as well as with the inhibition of B lymphocyte apoptosis.
文摘Lymphomatoid granulomatosis (LG) is an angiocentric lymphoproliferative disease. It usually involves lung, skin, and central nervous system, but splenomegaly and pancytopenia are the rare manifestations of the disease. We report a 15-year-old boy presented with fever, dry cough and dyspnea from two months ago, after admission patient had nodular lesions on the left leg and hepatosplenomegaly. Then he manifested neurologic signs such as seizure, aphasia and right-sided hemiplegia. Chest X-ray and CT scan revealed bilateral pulmonary nodules predominantly in lower lobes and peripheral lung fields. Laboratory exams showed pancytopenia. Skin biopsy was done, and histopathological examination and immunohistochemistry evaluation confirmed lymphomatoid granulomatosis. He was treated with steroid and cyclophosphamide but succumbed by neurologic involvement.
文摘The protocol and evaluation of I therapy have already been established, and it is quite effective in general for patients with metastatic thyroid cancer under 40 years old with fine or occult type of pulmonary metastases (papillary adenocarcinoma). However, the response of bone metastasis to I therapy is limited to only a part of tumors and is temporary in most cases although high I accumulation is visualized on scintigram. We have encountered a 65-year-old man with thyroid cancer. At the age of 61, follicular thyroid cancer with multiple bone metastasis was diagnosed, total thyroidectomy was carried out, and subsequently I therapy was performed. Bone pain diminished
