scholarly journals Visceral Leishmaniasis in a UK Toddler following a Short Trip to a Popular Holiday Destination in Spain

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Neda Minakaran ◽  
Talha Soorma ◽  
Shamez N. Ladhani
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Klebsiella Pneumoniae ◽  
Bone Marrow Biopsy ◽  
Haematological Malignancy ◽  
Short Trip ◽  
Initial Symptoms ◽  
The Uk

We herein present the case of a 15-month-old with visceral leishmaniasis diagnosed in the UK following a short trip to a popular holiday destination in Spain. Four months after the initial symptoms, the diagnosis was made incidentally on microscopy of a bone marrow biopsy taken for suspected haematological malignancy after the child developed hepatosplenomegaly, pancytopaenia, andKlebsiella pneumoniaesepticaemia.

scholarly journals Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

2012 ◽  
pp. 274-277
Author(s):  
Andrea Celestini ◽  
Federica Paglia ◽  
Orlando Dell’ Unto ◽  
Riccardo Guarisco ◽  
Claudio Puoti
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Splenic Rupture ◽  
Splenic Infarction ◽  
Diagnostic Tools ◽  
Minor Trauma ◽  
Vector Borne ◽  
A Minor

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.

Visceral Leishmaniasis: Bone Marrow Biopsy Findings

2007 ◽  
Vol 29 (2) ◽  
pp. 77-80 ◽  
Author(s):  
Perikala Vijayananda Kumar ◽  
Mohammad Vasei ◽  
Alireza Sadeghipour ◽  
Esmaeel Sadeghi ◽  
Hossein Soleimanpour ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy

scholarly journals Role of the Bone Marrow Examination among Undifferentiated Fever in Tropics

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Decision Making ◽  
Bone Marrow Aspiration ◽  
Clinical Decision ◽  
Bone Marrow Examination ◽  
Diagnostic Tools ◽  
P Value ◽  
Highly Sensitive

Background: Bone marrow aspiration and biopsy is one of the most important diagnostic tools for evaluation of undifferentiated fever. The positivity yield of these samples is highly specific that provides additional evidence for clinical decision making among the undifferentiated febrile cases. With this background we evaluated the bone marrow results of undifferentiated febrile cases for the last five years at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. The objective of the study was to measure the sensitivity of the bone marrow investigations among undifferentiated febrile cohort. Methods: A retrospective study was performed from January 2010 till December 2014 evaluating bone marrow reports. Completed request forms and the histopathological reports of the bone marrow specimens were reviewed. Statistical data was analyzed using SPSS 17 and p-value of <0.05 was considered significant. Results: Over the half decade 319 specimens were collected for bone marrow biopsy out of that 27% were requested for undifferentiated fever. The mean and median age of the biopsy performed patients was 35 and 31 years respectively. Among all biopsy samples 59% was adequate for evaluation however among the undifferentiated febrile cases biopsy samples only 45% was adequate for evaluation. The sensitivity of bone marrow biopsy was 34%. There were 714 bone marrow aspiration samples of that 84% was adequate for evaluation. The most common etiological diagnosis for the undifferentiated fever from the marrow evaluation was visceral leishmaniasis (53%). The sensitivity of the bone marrow aspiration and aspiration or biopsy for visceral leishmaniasis was 95% and 98% respectively. (p value 0.03) Conclusion: Bone marrow aspiration is highly sensitive and specific for the diagnosis of visceral leishmaniasis among the undifferentiated fever at tropics in Nepal.

scholarly journals An acute presentation of haemophagocytic lymphohistiocytosis due to visceral leishmaniasis in a British adult returning traveller

2019 ◽  
Vol 18 (3) ◽  
pp. 184-188
Author(s):  
Anastasia A Theodosiou ◽  
◽  
Hwai Jing Hiew ◽  
Christina Petridou ◽  
◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Bone Marrow Aspirate ◽  
Caucasian Woman ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
The Uk ◽  
Very High

A 62-year old British Caucasian woman normally resident in Spain presented with fever and pancytopaenia after returning to the UK. Her symptoms persisted despite broad-spectrum antibiotics, and she gradually became confused, hypotensive and progressively more pancytopaenic. Imaging demonstrated hepatosplenomegaly, and a bone marrow aspirate confirmed a diagnosis of haemophagocytic lymphohistiocytosis (HLH). Bone marrow polymerase chain reaction (PCR) and blood serology were both positive for Leishmania donovani, consistent with visceral leishmaniasis (VL). Following treatment with dexamethasone and amphotericin, she improved clinically and biochemically, and was able to return to Spain. Fever in the returning traveller is a common acute medical presentation. Although HLH and VL are rare diagnoses, both carry a very high mortality rate if undiagnosed and untreated.

Bone marrow biopsy in children: A study of 111 patients

1979 ◽  
Vol 6 (1) ◽  
pp. 57-64 ◽  
Author(s):  
C. Cozzutto ◽  
B. de Bernardi ◽  
A. Comelli ◽  
M. Guarino
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy

scholarly journals Evaluation of qPCR on blood and skin microbiopsies, peripheral blood buffy coat smear, and urine antigen ELISA for diagnosis and test of cure for visceral leishmaniasis in HIV-coinfected patients in India: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042519
Author(s):  
Sophie I Owen ◽  
Sakib Burza ◽  
Shiril Kumar ◽  
Neena Verma ◽  
Raman Mahajan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Hiv Infection ◽  
Peripheral Blood ◽  
Medical Science ◽  
Bone Marrow Aspiration ◽  
Buffy Coat ◽  
Tropical Medicine ◽  
Urine Antigen ◽  
Antigen Elisa

IntroductionHIV coinfection presents a challenge for diagnosis of visceral leishmaniasis (VL). Invasive splenic or bone marrow aspiration with microscopic visualisation of Leishmania parasites remains the gold standard for diagnosis of VL in HIV-coinfected patients. Furthermore, a test of cure by splenic or bone marrow aspiration is required as patients with VL-HIV infection are at a high risk of treatment failure. However, there remain financial, implementation and safety costs to these invasive techniques which severely limit their use under field conditions.Methods and analysisWe aim to evaluate blood and skin qPCR, peripheral blood buffy coat smear microscopy and urine antigen ELISA as non-invasive or minimally invasive alternatives for diagnosis and post-treatment test of cure for VL in HIV-coinfected patients in India, using a sample of 91 patients with parasitologically confirmed symptomatic VL-HIV infection.Ethics and disseminationEthical approval for this study has been granted by The Liverpool School of Tropical Medicine, The Institute of Tropical Medicine in Antwerp, the University of Antwerp and the Rajendra Memorial Research Institute of Medical Science in Patna. Any future publications will be published in open access journals.Trial registration numberCTRI/2019/03/017908.

A new model to predict remission status in AML patients based on day 14 bone marrow biopsy

2016 ◽  
Vol 46 ◽  
pp. 69-73 ◽  
Author(s):  
Maxim Norkin ◽  
Myron Chang ◽  
Qi An ◽  
Helen Leather ◽  
Lakshmikanth Katragadda ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
New Model ◽  
Remission Status

scholarly journals Molecular MRD status and outcome after transplantation in NPM1-mutated AML

Blood ◽  
2020 ◽  
Vol 135 (9) ◽  
pp. 680-688 ◽  
Author(s):  
Richard Dillon ◽  
Robert Hills ◽  
Sylvie Freeman ◽  
Nicola Potter ◽  
Jelena Jovanovic ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Residual Disease ◽  
Strong Predictor ◽  
Conditioning Regimen ◽  
Entire Cohort ◽  
National Cancer Research Institute ◽  
The Uk ◽  
Tandem Duplications ◽  
Donor Source

Abstract Relapse remains the most common cause of treatment failure for patients with acute myeloid leukemia (AML) who undergo allogeneic stem cell transplantation (alloSCT), and carries a grave prognosis. Multiple studies have identified the presence of measurable residual disease (MRD) assessed by flow cytometry before alloSCT as a strong predictor of relapse, but it is not clear how these findings apply to patients who test positive in molecular MRD assays, which have far greater sensitivity. We analyzed pretransplant blood and bone marrow samples by reverse-transcription polymerase chain reaction in 107 patients with NPM1-mutant AML enrolled in the UK National Cancer Research Institute AML17 study. After a median follow-up of 4.9 years, patients with negative, low (&lt;200 copies per 105ABL in the peripheral blood and &lt;1000 copies in the bone marrow aspirate), and high levels of MRD had an estimated 2-year overall survival (2y-OS) of 83%, 63%, and 13%, respectively (P &lt; .0001). Focusing on patients with low-level MRD before alloSCT, those with FLT3 internal tandem duplications(ITDs) had significantly poorer outcome (hazard ratio [HR], 6.14; P = .01). Combining these variables was highly prognostic, dividing patients into 2 groups with 2y-OS of 17% and 82% (HR, 13.2; P &lt; .0001). T-depletion was associated with significantly reduced survival both in the entire cohort (2y-OS, 56% vs 96%; HR, 3.24; P = .0005) and in MRD-positive patients (2y-OS, 34% vs 100%; HR, 3.78; P = .003), but there was no significant effect of either conditioning regimen or donor source on outcome. Registered at ISRCTN (http://www.isrctn.com/ISRCTN55675535).

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