scholarly journals Clostridium haemolyticum Infection: A Cause of Hemolytic Anemia in a Patient with Bone Marrow Necrosis

2021 ◽  
Vol 9 (8) ◽  
pp. 1568
Author(s):  
Anne Sophie Lagneaux ◽  
Sandrine Hénard ◽  
Laure Diancourt ◽  
Emmanuelle Stein ◽  
Pierre Perez ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Obese Woman ◽  
Molecular Techniques ◽  
Significant Past Medical History ◽  
Bone Marrow Necrosis ◽  
Rdna Sequencing ◽  
Oxygen Sensitive ◽  
Bacteremic Episode ◽  
Bone Marrow Regeneration

Clostridium haemolyticum is a sporulating Gram-positive anaerobic rod that is considered to be one of the most fastidious and oxygen-sensitive anaerobes. It is a well-known animal pathogen and the cause of bacillary hemoglobinuria primarily in cattle. To date, human infections caused by C. haemolyticum have been reported in three patients with malignant underlying diseases. We present herein the case of a 30-year-old obese woman with no significant past medical history who developed bacteremia caused by C. haemolyticum with massive intravascular hemolysis associated with bone marrow necrosis and acute renal failure. Because of subculture failure, the diagnosis was made on the basis of 16S rDNA sequencing and next-generation sequencing. The patient, who had been afebrile for 20 days after a 17-day-course of antibiotics, experienced a second bacteremic episode caused by C. haemolyticum. After having been successfully treated for 42 days with clindamycin and amoxicillin-clavulanic acid, the patient developed acute myeloid leukemia as a result of bone marrow regeneration. Although uncommon in humans, infections caused by C. haemolyticum are severe and should be considered in a febrile patient who has severe hemolytic anemia. This case also highlights the importance of using molecular techniques for the identification of this fastidious anaerobic organism.

scholarly journals Diagnostic approach of anemia in ruminants

2018 ◽  
Vol 69 (3) ◽  
pp. 1033 ◽  
Author(s):  
E. G. KATSOGIANNOU ◽  
L. V. ATHANASIOU ◽  
G. CHRISTODOULOPOULOS ◽  
Z. S. POLIZOPOULOU
Keyword(s):  
Bone Marrow ◽  
Hemolytic Anemia ◽  
Clinical Examination ◽  
Blood Count ◽  
Complete Blood Count ◽  
Vena Cava ◽  
Hemoglobin Concentration ◽  
Molecular Techniques ◽  
Diagnostic Approach ◽  
Mean Corpuscular Hemoglobin

Anemia in ruminants is an abnormal condition characterized by the decrease of the hematocrit (Packed Cell Volume, PCV), the mass of erythrocytes (Red Blood Cells, RBCs) and/or hemoglobin. Anemia is classified as hemolytic, hemorrhagic or anemia caused by the decreased production of erythrocytes; the first two categories are characterized by a regenerative response. Hemorrhagic anemia can be caused by ectoparasites or parasites of the gastrointestinal system, hemorrhagic bowel syndrome, abomasal ulcers, vena cava thrombosis as well as from the genitourinary tract. In addition, primary and secondary hemostatic disorders can be accompanied by hemorrhagic anemia. Hemoparasites, toxins produced from Clostridium perfringens type D and Clostridium hemolyticum and leptospirosis are some of the causes of hemolytic anemia. Furthermore, certain plants, drugs or heavy metals and lack of certain trace elements can cause hemolysis. Immune-mediated hemolytic anemia has also been reported in ruminants. The reduced production of erythrocytes can be caused by deficiency of vitamin B12 or iron, as well as by chronic diseases. Pathologic conditions of bone marrow like inflammatory or neoplastic cells filtration and hypoplasia or aplasia of bone marrow are related to reduced production of erythrocytes. After laboratory confirmation by complete blood count analysis, history taking, clinical examination of the animal and specific test depending on the case, are required for the diagnostic approach of anemia and especially for etiological diagnosis. Tachycardia, tachypnea, icterus, mucosal pallor as well as specific symptoms of the underlying disease are observed during the clinical examination of the animal. FAMACHA technique is widely used for the clinical diagnosis and the assessment of the severity of anemia. With respect to complete blood count, apart from the hematocrit, hemoglobin concentration, erythrocytes indices as Mean Corpuscular Volume (MCV) and Mean Corpuscular Hemoglobin Concentration (MCHC) are contributing to the classification of anemia. The size and the shape of the erythrocytes, the appearance of inclusions and reticulocytes, which are indicative of regenerative anemia, are evaluated in blood smear. Rarely, examination of bone marrow is carried out, for the differentiation of anemia as regenerative or non-regenerative. In particular, the confirmation of immune- mediate anemia is based on Coomb’s test for the detection of autoagglutination. Except from hemorrhage, blood loss is detected at urinalysis or feces microscopy for the presence of blood and/or parasites. Finally, serological and molecular techniques for the detection of infectious agents, as well as specific toxicological analysis are performed in various biological materials.

Bone marrow necrosis and fat embolism syndrome: a near fatal complication in previously undiagnosed sickle beta + thalassaemia

2021 ◽  
Vol 14 (1) ◽  
pp. e238317
Author(s):  
Nibash Budhathoki ◽  
Sunita Timilsina ◽  
Bebu Ram ◽  
Douglas Marks
Keyword(s):  
Bone Marrow ◽  
Multiorgan Failure ◽  
Rare Condition ◽  
Altered Mental Status ◽  
Fat Embolism ◽  
Bone Marrow Necrosis ◽  
Embolism Syndrome ◽  
Hb S ◽  
High Index Of Suspicion ◽  
Specific Symptoms

Prevalence of haemoglobin sickle-β+ thalassaemia (Hb S/β+thal) is variable with geography ranging from 0.2% to 10% among sickle cell patients. Clinical presentation of Hb S/β+thal patients depends on HbA level, with milder disease often going undiagnosed. However, rarely these patients can present with a fulminant vaso-occlusive crisis (VOC). Given VOC can present with non-specific symptoms, the diagnosis and treatment is often delayed. Here, we present a patient who initially developed altered mental status, pancytopenia and multiorgan failure due a critical VOC resulting in bone marrow necrosis and fat embolism. Subsequent workup confirmed that our patient had Sickle-β+ thalassaemia, which had gone undiagnosed, despite subclinical evidence of haemolysis on routine lab work for years. Following diagnosis and initiation of RBC exchange, he improved significantly and was discharged home. High index of suspicion and bone marrow biopsy is vital for early diagnosis and management of this rare condition.

scholarly journals Evidence for complement-mediated bone marrow necrosis in a young adult with sickle cell disease

2021 ◽  
Vol 86 ◽  
pp. 102508
Author(s):  
Melissa Azul ◽  
Surbhi Shah ◽  
Sarah Williams ◽  
Gregory M. Vercellotti ◽  
Alexander A. Boucher
Keyword(s):  
Bone Marrow ◽  
Young Adult ◽  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Cell Disease ◽  
Bone Marrow Necrosis

scholarly journals Massive Bone Marrow Necrosis with Polyclonal Hypergammaglobulinemia and Blue Toe Syndrome

Hematology ◽  
2000 ◽  
Vol 5 (2) ◽  
pp. 163-165 ◽  
Author(s):  
Tohru Murayama ◽  
Yoshitake Hayashi ◽  
Shion Imoto ◽  
Manabu Shimoyama ◽  
Hiroshi Matsuoka ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Necrosis ◽  
Polyclonal Hypergammaglobulinemia ◽  
Blue Toe Syndrome ◽  
Massive Bone

Bone Marrow Necrosis

2009 ◽  
Vol 214 (4) ◽  
pp. 331-336 ◽  
Author(s):  
PETER V. HANSEN ◽  
JØRN ANDERSEN ◽  
HENRIK MYGIND
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Necrosis

scholarly journals The rare hemoglobin variant Hb Mizuho: report of a Swiss family and literature review

2021 ◽  
Author(s):  
Linet Njue ◽  
Cesare Medri ◽  
Peter Keller ◽  
Miriam Diepold ◽  
Behrouz Mansouri Taleghani ◽  
...  
Keyword(s):  
Literature Review ◽  
Hemolytic Anemia ◽  
De Novo ◽  
Clinical History ◽  
Molecular Techniques ◽  
De Novo Mutation ◽  
First Case ◽  
History Of ◽  
Transfusion Dependency ◽  
Unstable Hemoglobin

AbstractHb Mizuho is a very rare unstable hemoglobin; here, we describe the clinical history of three Swiss family members with Hb Mizuho together with a systematic review of the previously six published cases. The clinical history of the adult woman we report here is unique since this is the first Hb Mizuho presenting with Moyamoya complications and the first case reported with long-term erythrocyte exchange. The literature review showed that Hb Mizuho was mainly reported as a de novo mutation, with the exception of children descended from known cases. All published patients with this unstable hemoglobin showed severe hemolytic anemia with the exception of one; all were regularly transfused. Patients with higher HbF levels might require fewer transfusions. All patients underwent splenectomy at a median age of 4 years and had variable clinical improvement; some achieved complete resolution of transfusion dependency after splenectomy. Iron overload in Hb Mizuho patients seems to be mainly attributed to transfusions and has less to do with ineffective erythropoiesis. Diagnosis might be challenging; a normal hemoglobin electrophoresis should not rule out the diagnosis of unstable hemoglobin in patients with otherwise unexplained hemolytic anemia. This series shows the enormous utility of using molecular techniques for diagnosis.

scholarly journals Bone marrow necrosis in neuroendocrine tumor of the thymus

2018 ◽  
Vol 6 (10) ◽  
pp. 1970-1971
Author(s):  
Benoît Ducourneau ◽  
Claire Hemar
Keyword(s):  
Bone Marrow ◽  
Neuroendocrine Tumor ◽  
Bone Marrow Necrosis

scholarly journals Bone Marrow Regeneration Using Adipose-Derived Stem Cells

2006 ◽  
Vol 73 (1) ◽  
pp. 45-47 ◽  
Author(s):  
Rei Ogawa ◽  
Hiroshi Mizuno ◽  
Hiko Hyakusoku ◽  
Takashi Shimada
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Adipose Derived Stem Cells ◽  
Bone Marrow Regeneration

scholarly journals A Case of Malignant Lymphoma with Bone Marrow Necrosis

2008 ◽  
Vol 57 (2/3) ◽  
pp. 31-35
Author(s):  
Hiroko NAKABAYASHI ◽  
Manabu KONDO ◽  
Takayuki TOMINAGA ◽  
Kenji SHINOHARA ◽  
Toshiaki KAMEI
Keyword(s):  
Bone Marrow ◽  
Malignant Lymphoma ◽  
Bone Marrow Necrosis
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