Publications by authors named "Jugraj Dhanoa"

4 Publications

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Carfilzomib-induced atypical haemolytic uraemic syndrome: a diagnostic challenge and therapeutic success.

BMJ Case Rep 2021 Feb 26;14(2). Epub 2021 Feb 26.

Department of Blood & Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA

Haemolytic uraemic syndrome (HUS) is a thrombotic microangiopathy (TMA) that presents with renal insufficiency, thrombocytopaenia and microangiopathic haemolytic anaemia. Typical HUS is associated with Shiga toxin while atypical HUS (aHUS) is due to overactivation of the alternative complement pathway. aHUS has numerous causes, including drugs, with rare reports of carfilzomib, a proteasome inhibitor used in multiple myeloma, as causative agent. Cases vary in presentation, presenting a diagnostic challenge. Historically, TMAs were treated with plasma exchange. aHUS, however, is considered refractory to plasma exchange and best treated with eculizumab, a monoclonal antibody targeting C5, a terminal complement protein. We report a patient with history of multiple myeloma who presented with headaches, elevated blood pressure, petechiae, ecchymosis and haemolytic anaemia. His condition was determined to be carfilzomib-induced aHUS and he was successfully treated with eculizumab. Early detection and treatment of drug-induced aHUS is vital in reducing morbidity and mortality related to the condition.
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http://dx.doi.org/10.1136/bcr-2020-239091DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919563PMC
February 2021

Clinical Outcomes Using Mycophenolate and Tacrolimus for Graft-versus-Host Disease Prophylaxis in Patients Undergoing Allogeneic Stem Cell Transplant: A Single Institution Experience.

Cureus 2020 Feb 5;12(2):e6893. Epub 2020 Feb 5.

Division of Blood and Marrow Transplant, University of Louisville, Louisville, USA.

For recipients of allogeneic hematopoietic stem cell transplant (HSCT), mycophenolate mofetil (MMF) plus tacrolimus combination is mostly used in reduced-intensity (RIC), and nonmyeloablative conditioning (NMAC) whereas methotrexate and tacrolimus combination is preferred in myeloablative conditioning (MAC). We present single institution outcomes in patients undergoing allogeneic HSCT with both MAC and NMAC/RIC regimen using MMF and tacrolimus for graft-versus-host disease (GVHD) prophylaxis. Data from all adult patients who underwent allogeneic HSCT from 2007 to 2017 was collected from Data Back to Centers web-based application of Center for International Blood and Marrow Transplant Research (CIBMTR). A total of 150 patients were included with the mean age of 46.9 years. For the patients who received MAC (n=109), the cumulative incidence of grade II-IV acute GVHD at day 100 was 37%, grade II-IV acute GVHD at one year was 51%, and chronic GVHD at one year was 38%. For the patients who received NMAC/RIC (n=41), the cumulative incidence of grade II-IV acute GVHD at day 100 was 31%, grade II-IV acute GVHD at one year was 28%, and chronic GVHD at one year was 36%. This institutional analysis shows that the combination of MMF and tacrolimus yields acceptable outcomes for the prevention of acute and chronic GVHD.
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http://dx.doi.org/10.7759/cureus.6893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7058400PMC
February 2020

Rare case of Bing-Neel syndrome treated successfully with ibrutinib.

BMJ Case Rep 2019 Jun 25;12(6). Epub 2019 Jun 25.

Blood and Marrow Transplant, University of Louisville School of Medicine, Louisville, Kentucky, USA.

Waldenstrom's macroglobulinaemia (WM) is a lymphoproliferative disorder of the B cell origin. It is characterised by the presence of IgM paraprotein in the serum and lymphoplasmacytic lymphoma cells in the bone marrow with extranodal involvement relatively uncommon. Bing-Neel syndrome (BNS) is a neurological complication of WM that results from infiltration of the central nervous system by malignant lymphoplasmacytic cells. We present an interesting case of BNS that responded remarkably to ibrutinib monotherapy.
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http://dx.doi.org/10.1136/bcr-2019-230067DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6605891PMC
June 2019

Trigeminal Amyloidoma: Case Report and Review of Literature.

Cureus 2018 Dec 28;10(12):e3795. Epub 2018 Dec 28.

Internal Medicine, Saint Francis Hospital and Medical Center, Grand Island, USA.

Amyloid is an abnormal insoluble protein that can deposit in extracellular space. It can involve nearly any organ system and may manifest as a systemic process or focal lesion (amyloidoma). We present a rare case of localized amyloidosis with trigeminal nerve being the only site of involvement and no evidence of systemic disease. We also review literature relevant to trigeminal amyloidoma and make recommendations for diagnosis and treatment.
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http://dx.doi.org/10.7759/cureus.3795DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402733PMC
December 2018