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Indian J Thorac Cardiovasc Surg 2022 Jul 12;38(Suppl 2):290-299. Epub 2021 Oct 12.

Lung Transplant Program, University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd. Suite 603, Dallas, TX 75235-8550 USA.

Lung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. Read More

Cureus 2022 May 18;14(5):e25096. Epub 2022 May 18.

Internal Medicine, BronxCare Health System, Bronx, USA.

Atypical hemolytic uremic syndrome (HUS) is a rare but severe form of thrombotic microangiopathies (TMAs) that affects both children and adults. The clinical presentation is usually nonspecific, including a broad spectrum of symptoms ranging from abdominal pain, confusion, diarrhea, fatigue, irritability, hypertension, and lethargy. We present a case of a 36-year-old woman with medical comorbidities of asthma and pulmonary embolism who presented to our hospital in the 36th week of her pregnancy for preterm premature rupture of the membranes. Read More

Medicine (Baltimore) 2022 Jun 17;101(24):e29403. Epub 2022 Jun 17.

Nursing Graduate Program, Federal University of Rio Grande do Norte, Natal, Brazil.

Introduction: Uterine cervix tumors have an invasive nature, with the capacity to proliferate to surrounding organs such as the vagina, bladder, and rectum, as well as the capacity for dissemination and involvement of structures distant from its place of origin. According to the International Federation of Gynecology and Obstetrics, patients with stages IB I, IB I microscopic (small dimension <4 cm) are indicated for radiotherapy or adjuvant chemoradiotherapy with cisplatin (40 mg/m2). However, cisplatin has side effects such as hematological implications (anemia, neutropenia, and thrombocytopenia), gastrointestinal disorders (nausea, vomiting, diarrhea, constipation), and fatigue. Read More

Haematologica 2022 06 16. Epub 2022 Jun 16.

Weill Cornell Medicine - Division of Hematology and Medical Oncology, 1300 York Ave. A603A, New York, New York 10065.

This article summarizes our approach to the diagnosis, secondary ITP, and choice of second line options in patients with immune thrombocytopenic (ITP). We very briefly summarize first-line treatment and then utilize a case-based approach. We will first explore persistent-chronic ITP in a younger female. Read More

J Gynecol Obstet Hum Reprod 2022 Jun 7;51(7):102422. Epub 2022 Jun 7.

Obstetrics and Fetal medicine Unit, CHRU of Nancy, Nancy, France; Université de Lorraine, Inserm, IADI, F-54000 Nancy, France.

In pregnant women, Thrombotic Thrombocytopenic Purpura (TTP) mimics severe preeclampsia because of the overlapping of these symptoms. We report the case of a 28-years-old woman who presented severe thrombocytopenia (platelets at 34 G/L) at 31 gestational weeks. The day after, she showed anaemia, worsening thrombocytopenia (platelets at 6 G/L) and an isolated increase of AST (91 UI/L). Read More

Lupus Sci Med 2022 05;9(1)

Department of Clinical Epidemiology, The First Hospital of Jilin University, Changchun, China

Objectives: Based on clinical and laboratory indicators, this study aimed to establish a multiparametric nomogram to assess the risk of refractory cases of SLE-related thrombocytopenia (SLE-related TP) before systematic treatment.

Methods: From June 2012 to July 2021, a dual-centre retrospective cohort study of prospectively collected data of patients with SLE-related TP was conducted. The cohort data were divided into a developing set, internal validation set and external validation set. Read More

Pan Afr Med J 2022 22;41:154. Epub 2022 Feb 22.

Unit of Obstetrics and Gynaecology, Department of Primary Health Care Sciences, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe.

Malaria in pregnancy is associated with significant morbidity and mortality, and requires early diagnosis and intervention. Plasmodium falciparum is responsible for 98% of malaria cases in Zimbabwe and causes the most severe disease. Abnormal haematological parameters are a frequent finding in patients with malaria; however, they are rarely the sole presenting feature. Read More

J Med Case Rep 2022 May 13;16(1):203. Epub 2022 May 13.

Department of Obstetrics, Perinatal Center, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyohama Chuo-ku, Fukuoka, 810-8563, Japan.

Background: Gaucher disease is an autosomal recessive inborn error of metabolism that causes disorders of blood, bone, and central nervous system as well as hepatosplenomegaly. We present the case of a carrier of Gaucher disease with gestational thrombocytopenia and anemia that required blood transfusion therapy.

Case Presentation: A 24-year-old Nepalese primipara was diagnosed with idiopathic thrombocytopenia at 12 weeks of gestation. Read More

J Coll Physicians Surg Pak 2022 May;32(5):646-651

Chongqing Key Laboratory of Pediatrics, Chongqing, China.

Objective: To compare the clinical characteristics of necrotizing enterocolitis (NEC) and food protein-induced enterocolitis (FPIES) when both have pneumatosis intestinalis (PI) and to identify them.

Study Design:  Analytical study.

Place And Duration Of Study:  Department of Neonatology, Children's Hospital of Chongqing Medical University, Chongqing, China, from January to December 2019. Read More

Rev Esp Anestesiol Reanim (Engl Ed) 2022 04 7;69(4):245-248. Epub 2022 May 7.

Anestesiología y Reanimación, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.

Atypical uremic haemolytic syndrome is a variant of thrombotic micro-andiopathy characterized by non-autoimmune hemolytic anemia, thrombocytopenia and acute renal failure as a result of excessive activation of the complement. Up to 60% of patients have mutations in the genes that encode the complement system. A disensing factor is required for its manifestation, including gestation. Read More

Rheumatology (Oxford) 2022 May 10. Epub 2022 May 10.

Department of Rheumatology, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China.

Objectives: Thrombocytopenia, a frequent clinical manifestation in patients with antiphospholipid syndrome (APS), could be an independent predictor of recurrent thrombotic, obstetrical and severe extra-criteria events.

Methods: This single-center prospective study enrolled 218 consecutive patients diagnosed with primary APS between 2010 to 2021. Thrombocytopenia was defined as a platelet count <100 × 109/L. Read More

Arch Clin Cases 2022 6;9(1):24-28. Epub 2022 Apr 6.

CMH Lahore Medical College, Lahore, Punjab, Pakistan.

We report a case of thrombotic microangiopathy in a postpartum female for which considerable diagnostic uncertainty existed initially regarding the etiology. This case highlights the limitations surrounding PLASMIC scoring criteria for the diagnosis of thrombotic thrombocytopenic purpura (TTP). A 32-year-old woman presented to maternofetal medicine in her third trimester of pregnancy at 32 weeks for a routine follow up and was subsequently found to have elevated blood pressures with proteinuria, and was diagnosed with pre-eclampsia. Read More

Front Immunol 2022 12;13:860689. Epub 2022 Apr 12.

Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, Université de Paris, Paris, France.

As part of the innate immune system, the complement system plays a key role in defense against pathogens and in host cell homeostasis. This enzymatic cascade is rapidly triggered in the presence of activating surfaces. Physiologically, it is tightly regulated on host cells to avoid uncontrolled activation and self-damage. Read More

BMC Vet Res 2022 Apr 27;18(1):152. Epub 2022 Apr 27.

Faculty of Agricultural Sciences, Institute of Animal Science, University of Hohenheim, Schwerzstr. 15/4, 70599, Stuttgart, Germany.

Background: In animals, only few reports exist about the occurrence and causes of subconjunctival bleedings, especially in newborn calves. Most case reports and studies showed that the major risk factors for subconjunctival bleedings in animals are traumatic events such as birth trauma and traffic accidents, respectively. In neonatal babies, it is suggested that compression of the thorax and abdomen during delivery or forces generated in utero during labor may raise venous pressure to conjunctival vessels and can cause subconjunctival bleedings. Read More

Cureus 2022 Mar 25;14(3):e23490. Epub 2022 Mar 25.

Hematology, National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, PAK.

Objective: The study aimed to evaluate the causes of thrombocytopenia in pregnancy and its management along with the outcome in the COVID-19 era.

Methods: Recruitment for this prospective, cross-sectional observational study of thrombocytopenia in pregnancy (platelet counts <100x10/L) was done from January 2017 to August 2020 at the National Institute of Blood Diseases (NIBD) after taking the patients' informed consent. Complete clinical and lab profile of patients was also collected. Read More

J Assoc Physicians India 2022 Apr;70(4):11-12

Armed Forces Medical College, Pune, Maharashtra; 2Command Hospital (Southern Command), Pune, Maharashtra.

Antiphospholipid anti body syndrome is an autoimmune disorder characterized by arterial or venous thrombosis and/or pregnancy morbidity with foetal deaths or abortions in the presence of antiphospholipid antibodies. Catastrophic antiphospholipid antibody syndrome (CAPS) is an accelerated form of disease with rapid involvement of multiple organ systems often posing a diagnostic challenge. There is a paucity of literature on the presentations of CAPS owing to the orphan nature of the disease. Read More

BMC Nephrol 2022 04 15;23(1):147. Epub 2022 Apr 15.

Department of Pediatric Nephrology, Cincinnati Children's Hospital Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.

Background: This report introduces an unusual cause of kidney failure in a previously healthy pediatric patient. She developed thrombotic microangiopathy (TMA) that was diagnosed post-partum, requiring dialysis and eculizumab, with eventual recovery of kidney function ([chronic kidney disease (CKD) stage 3].

Case Presentation: The patient was induced at term due to preeclampsia, with delivery complicated by severe postpartum hemorrhage from uterine atony. Read More

Paediatr Int Child Health 2022 Apr 10:1-6. Epub 2022 Apr 10.

Department of Paediatrics, Vani Vilas Hospital, Bangalore Medical College and Research Institute, Bengaluru, India.

Untreated syphilis in pregnancy can result in an adverse outcome for the fetus. A multigravida woman with a previously poor obstetric history of early neonatal death, abortion and stillbirth was admitted in labour in the 7th month of pregnancy. On admission, syphilis screening with the qualitative rapid plasma reagin (RPR) test was negative. Read More

J Med Case Rep 2022 Mar 14;16(1):103. Epub 2022 Mar 14.

Department of Medicine, Limmattal Hospital, 100 Urdorferstrasse, 8952, Schlieren, ZH, Switzerland.

Background: The differential diagnosis of abdominal pain in pregnant women is broad. Liver diseases as the origin of abdominal pain in pregnancy are rare, and severe forms occur in less than 0.1% of pregnancies. Read More

J Med Primatol 2022 06 9;51(3):195-198. Epub 2022 Mar 9.

Department of Experimental Animal Research, Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea.

A pregnant common marmoset (Callithrix jacchus) showed tachypnea, hypothermia, and anorexia at close to the expected delivery date. Severe anemia and thrombocytopenia, schistocytes, and high levels of LDH and D-dimer were observed. Three days after the onset of clinical signs, a cesarean section was conducted due to stillbirth. Read More

Pediatr Rheumatol Online J 2022 Feb 23;20(1):17. Epub 2022 Feb 23.

Department of Internal Medicine, Division of Rheumatology, University of Michigan, 1150 West Medical Center Drive, Ann Arbor, MI, 48109, USA.

Background/purpose: Pediatric antiphospholipid syndrome (APS) is a thromboinflammatory disease characterized by the presence of circulating antiphospholipid antibodies and either thrombotic events or pregnancy morbidity. The objective of this study was to review a large institution's experience to better understand the characteristics of children with APS.

Methods: We conducted a retrospective review of pediatric APS at a tertiary referral center. Read More

Clin Med (Lond) 2021 07;21(4):e403-e404

Hospital of Wales, Cardiff, UK.

J Clin Med 2022 Feb 1;11(3). Epub 2022 Feb 1.

CHU Bordeaux, Internal Medicine Department, F-33000 Bordeaux, France.

Thrombotic microangiopathy (TMA) gathers consumptive thrombocytopenia, mechanical haemolytic anemia, and organ damage. Hemolytic uremic syndromes (HUS) are historically classified as primary or secondary to another disease once thrombotic thrombocytopenic purpura (TTP), Shiga-toxin HUS, and cobalamin C-related HUS have been ruled out. Complement genetics studies reinforced the link between complement dysregulation and primary HUS, contributing to reclassifying some pregnancy- and/or post-partum-associated HUS and to revealing complement involvement in severe and/or refractory hypertensive emergencies. Read More

Wiad Lek 2022 ;75(1):128-131

DANYLO HALYTSKY LVIV NATIONAL MEDICAL UNIVERSITY, LVIV, UKRAINE.

Pregnancy-associated renal thrombotic microangiopathy is a rare condition with poor maternal outcome. Pregnancy may trigger atypical hemolytic uremic syndrome or thrombotic thrombocytopenic purpura. The article describes the clinical case of a 37-year-old woman who developed acute renal failure following complicated delivery. Read More

Ugeskr Laeger 2022 01;184(2)

Gynækologisk Obstetrisk Afdeling, Holbæk Sygehus.

This is a case report of a 24-year-old woman at pregnancy week 30, who presented with abdominal pain, nausea, dizziness, fatigue, intermittent headaches, and hyperreflexia. Haemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome was suspected due to blood tests showing low haemoglobin- and thrombocyte levels, and elevated lactate dehydrogenase level. The baby was delivered by acute caesarean section shortly after hospitalization. Read More

J Blood Med 2021 7;12:1045-1056. Epub 2021 Dec 7.

Foundation FEETEG, Zaragoza, Spain.

Purpose: Gaucher disease (GD) is the most common lysosomal storage disorder. The principal manifestations for its diagnosis and further monitoring include haematological manifestations such as anaemia, thrombocytopaenia, spleen enlargement, and bleeding disorders, among others. This review aims to summarise and update the role of haematological complications in GD diagnosis and follow-up, describe their management strategies, and to use these indicators as part of the diagnostic approach. Read More

J Med Case Rep 2021 Dec 13;15(1):606. Epub 2021 Dec 13.

Department of Hematology Medical-Oncology, Dr. Kariadi General Hospital, Semarang, Indonesia.

Background: In this report, we describe a very challenging case of a patient with secondary Evans syndrome caused by severe coronavirus disease 2019 infection in a pregnant full-term woman.

Case Presentation: A 29-year-old full-term pregnant Indonesian woman presented with gross hematuria, dry cough, fever, dyspnea, nausea, anosmia, and fatigue 5 days after confirmation of coronavirus disease 2019 infection. Laboratory examinations showed very severe thrombocytopenia, increased indirect bilirubin, and a positive direct Coombs' test. Read More

Hematology Am Soc Hematol Educ Program 2021 12;2021(1):545-551

Department of Haematology, University College London Hospitals NHS Foundation Trust and Cardiometabolic Programme-NIHR UCLH/UC BRC, London, UK.

Thrombotic microangiopathy (TMA) is the broad definition for thrombocytopenia, microangiopathic hemolytic anemia, and end-organ damage. Two important categories are thrombotic thrombocytopenic purpura (TTP) and complement-mediated hemolytic-uremic syndrome (CM-HUS). Pregnancy and the immediate postpartum period are associated with TMAs specific to pregnancy in rare situations. Read More