Mizuho hemoglobinopathy, presenting with severe hemolytic anemia and multisystem organ failure secondary to exertion

Transfusion ◽  
2021 ◽  
Author(s):  
Tania T. Sarker ◽  
Bhavesh Delvadia ◽  
Shiyong Li ◽  
John D. Roback ◽  
Ross M. Fasano ◽  
...  
Keyword(s):  
Organ Failure ◽  
Hemolytic Anemia ◽  
Multisystem Organ Failure

scholarly journals Ceftizoxime-induced immune hemolytic anemia associated with multi-organ failure

2017 ◽  
Vol 34 (1) ◽  
pp. 123-127 ◽  
Author(s):  
Jin Young Huh ◽  
Ari Ahn ◽  
Hyungsuk Kim ◽  
Seog Woon Kwon ◽  
Sujong An ◽  
...  
Keyword(s):  
Organ Failure ◽  
Hemolytic Anemia ◽  
Multi Organ Failure ◽  
Immune Hemolytic Anemia

Colectomy for Fulminant Clostridium difficile Colitis: Predictors of Mortality

2010 ◽  
Vol 76 (4) ◽  
pp. 418-421 ◽  
Author(s):  
Anton Dias Perera ◽  
Robert P. Akbari ◽  
Michael S. Cowher ◽  
Thomas E. Read ◽  
James T. Mccormick ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Clostridium Difficile ◽  
Serum Albumin ◽  
Organ Failure ◽  
Univariate Analysis ◽  
Postoperative Mortality ◽  
Clinical Variable ◽  
Symptom Duration ◽  
Multisystem Organ Failure ◽  
Clostridium Difficile Colitis

The purpose of this study was to define clinical and radiographic variables associated with postoperative mortality after urgent colectomy for fulminant Clostridium difficile colitis. Data were obtained regarding patients undergoing colectomy for fulminant C. difficile colitis at two institutions (1997-2005). Univariate analysis of factors predicting 30-day mortality was performed using χ2 and Student's t tests. Multivariable logistic regression was done to include all variables whose P value was < 0.20. Clinical variables analyzed included: age, gender, recent operation, comorbidities, preoperative multisystem organ failure, vasopressors, symptom duration, time to surgery, serum albumin, change in serum albumin, serum creatinine, white blood cell count, and extent of colectomy. Computed tomography variables included: ascites, megacolon, and extent of colitis. Thirty-five patients (mean age 70 years, 46% male) underwent urgent colectomy for C. difficile colitis. The 30-day mortality rate was 45.7 per cent (16/35). The only clinical variable associated with mortality was preoperative multisystem organ failure (non-survivors 9/16 vs survivors: 4/19; P = 0.037). None of the three patients undergoing partial colectomy survived, although the difference in survival versus those undergoing subtotal colectomy was not significant. Patients with fulminant C. difficile colitis undergoing colectomy have a high mortality rate. Preoperative presence of multisystem organ failure was independently predictive of mortality.

Interim Report of a Randomized, Open-Label, Multicenter Study to Evaluate the Safety and Efficacy of Decitabine As an Epigenetic Priming Agent When Combined with Induction Chemotherapy in Pediatric Patients (pts) with Newly Diagnosed Acute Myelogenous Leukemia (AML)

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1517-1517
Author(s):  
Lia Gore ◽  
Margaret E. Macy ◽  
Francoise Mechinaud ◽  
Aru Narendran ◽  
Frank Alvaro ◽  
...  
Keyword(s):  
Organ Failure ◽  
Induction Therapy ◽  
Expression Patterns ◽  
Myelogenous Leukemia ◽  
Colon Perforation ◽  
Cell Transplant ◽  
Newly Diagnosed ◽  
Open Label ◽  
Post Induction ◽  
Multisystem Organ Failure

Abstract Abstract 1517 Purpose: Decitabine, a deoxycytidine nucleoside derivative, is an inhibitor of DNA-methyltransferases indicated for treatment of myelodysplastic syndrome (MDS) including previously treated and untreated, de novo or secondary MDS of all French-American-British (FAB) subtypes, Intermediate-1, Intermediate-2, and High-Risk International Prognostic Scoring System (IPSS) groups. Laboratory evidence shows that pretreatment of AML cell lines can sensitize leukemia cells to chemotherapy as well as inhibit clonogenic potential. The purpose of this study is to evaluate the safety, pharmacokinetics, and efficacy of decitabine when used as priming before induction therapy in children with newly diagnosed AML. Exploratory analyses of genomic methylation and RNA expression patterns and minimal residual disease (MRD) are embedded correlative studies. Methods: This multicenter, randomized, two-arm, open-label study enrolls pediatric pts ages 1–16 with newly diagnosed AML to either Arm A: daunorubicin, cytarabine, etoposide (D-ADE) preceded by a 5-day course of decitabine (experimental arm) or Arm B: daunorubicin, cytarabine, etoposide (ADE; control arm). Following completion of induction on study, post-induction therapy is at the treating physician's discretion. To date, 20 pts, 10 in each arm (1–16 yrs, median 9.4 yrs in both arms) have been enrolled. Results: At the protocol-specified bone marrow sampling time 3 weeks post-induction, there were 2 CRs, 6 CRi (CR with incomplete hematopoietic recovery), 1 leukemia not in remission and 1 pt who discontinued due to an AE in Arm A. In Arm B, 6 CRs, 2CRi, 1 PR and 1 pt with marrow aplasia have been confirmed. Decitabine PK in all arm A pts (100%) were characterized by mean+SD Cmax, 297+109 ng/mL, AUC0-t, 216+73.7 ng*h/mL, CL, 136+93.9L/h, Vdss 93.1+70.7 L, t1/2 0.456+0.073 h, and median tmax0.925 h. All pts had at least one AE. Grade 3 and 4 non-hematologic AEs in Arm A that were not seen in Arm B were caecitis in 2 (20%), anorexia in 3 (30%), and hypophosphatemia in 2 (20%) of pts. All pts experienced neutropenia and thrombocytopenia as expected. One pt in Arm A had appendicitis and colon perforation on Day 6 that led to study discontinuation, later determined to have been leukemic infiltrate. Two pts have died to date (both in Arm A), one of necrotic bowel, Pseudomonas sepsis and multisystem organ failure 6 months after completing study induction therapy. One pt died 5 months following study treatment from multisystem organ failure after stem cell transplant. Epigenetic changes associated with decitabine pretreatment were analyzed and will be presented. Conclusions: Decitabine in combination with ADE chemotherapy is well tolerated in children with newly diagnosed AML. There were no AEs that had not been previously identified in adults with MDS or AML. No differences have been observed between treatment arms in hematologic toxicities based on the current sample size. To date, the decitabine-treated pts in this study may have more gastrointestinal toxicity and hypophosphatemia. Decitabine-treated pts achieved PK exposures that were similar to those observed in adults treated with decitabine. Preliminary responses by CR/CRi were similar between treatment arms; expected adverse events of neutropenia and thrombocytopenia were similar between both Arms. Molecular changes associated with decitabine pretreatment may be important in the sensitization of clonogenic AML cells. Total accrual of 40 subjects is planned. Disclosures: Off Label Use: AC220 in relapsed/refractory pediatric acute leukemia. Tarassoff:Eisai, Inc.: Employment. Jones:Eisai Inc: Employment.

Multisystem Organ Failure in Neurosurgical Patients

CHEST Journal ◽  
1991 ◽  
Vol 100 (3) ◽  
pp. 203S-204S ◽  
Author(s):  
A. Unterberg ◽  
R. Murr ◽  
K. Kiening
Keyword(s):  
Organ Failure ◽  
Multisystem Organ Failure ◽  
Neurosurgical Patients
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