1/11. Long-lasting intestinal bleeding in an old patient with multiple mucosal vascular abnormalities and Glanzmann's thrombasthenia: 3-year pharmacological management.A 75-year-old woman with Glanzmann's thrombasthenia was admitted because of persistent melaena. Endoscopic examination showed multiple angiodysplastic lesions, with active bleeding in small and large bowel. Electro-coagulation of some lesions, octreotide, conjugated oestrogens and selective embolization of jejunal vessels did not change transfusion requirements. After 8 month-transfusions, ethinylestradiol norethisterone in association with octreotide was started, leading to no transfusion over the following 9 months. Bleeding recurred after withdrawing octreotide and substituting ethinylestradiol norgestrel for the ethinylestradiol norethisterone combination. Re-introduction of octreotide did not improve bleeding; however, a reduction of transfusion requirement was observed when the ethinylestradiol norethisterone pill was re-administered. The association of octreotide and of an oestrogen-progesterone combination was helpful in the difficult management of recurrent bleeding in this patient with diffuse gastrointestinal vascular abnormalities and a severe condition predisposing to bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/11. Normocytic normochromic anemia due to automatic neuropathy in type 2 diabetic patients without severe nephropathy: a possible role of microangiopathy.We describe here four male patients with long-term and poorly controlled type 2 diabetes mellitus. They shared many common characteristic complications, such as severe autonomic neuropathy, proliferative retinopathy and normocytic normochromic anemia without progressive renal failure and macroangiopathy. They also showed normal levels of erythropoietin and reticulocyte, which was considered relatively low. The coefficient of variation of R-R, a useful method to estimate autonomic failure, showed markedly advanced autonomic neuropathy in all four patients. coronary angiography did not reveal stenosis, anomaly or collateral vessels, but left ventriclography showed diffuse or partial hypokinesis. Massive proteinuria, high urinary levels of N-acetyl-beta-D-glucosamidase (NAG) and beta2-microglobulin (beta2M) were detected, though creatinine clearance (Ccr) was not so deteriorated. Treatment with recombinant erythropoietin increased their hemoglobin and hematocrit levels. These common points have a possibility to be brought about by tubulointerstitial damage and microangiopathy may be involved in it.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/11. Prenatal management of placental chorioangioma: value of the middle cerebral artery peak systolic velocity.Placental chorioangiomas are benign tumors of the placenta. Large chorioangiomas may cause severe complications such as fetal anemia, hydrops and fetal death. We report the use of sonographic findings and peak systolic velocity in the middle cerebral artery in the diagnosis and management of fetal anemia without the occurrence of hydrops fetalis in a pregnant woman with a large placental chorioangioma. Successful intrauterine blood transfusion was performed at 26 weeks. Spontaneous thrombosis of the main supplying blood vessel of the chorioangioma was detected at 33 weeks. The child was delivered at 39 weeks of pregnancy in normal clinical condition.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/11. Chronic bronchopneumonia with recurrent hemoptyses and resultant severe anemia.A female patient, 69 years old, was hospitalized because of a 2-year history of recurrent hemoptyses resulting in severe anemia. X-ray examination of the chest showed a mass lesion in the right lower lung field, which had grown over the preceding 2 years. Bronchographic, arteriographic and CT examinations excluded the possibilities of bronchiectasis, pulmonary A-V fistula or sequestration. Histological examination following right lower lobectomy revealed no evidence of neoplasms or tuberculosis, fungal and parasitic infections but showed a predominant mononuclear cell infiltration and abundant small vessels in the affected small bronchi, and peribronchiolar and adjacent alveolar regions. To our knowledge, no case with chronic bronchopneumonia accompanied by such massive hemoptyses, as seen in this case, has been reported to date.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/11. A case of neoplastic angioendotheliomatosis: angiotropic lymphoma.An autopsy case of neoplastic angioendotheliomatosis (NAE) in a 65-year-old male is reported. At autopsy, the paraaortic lymph node was slightly enlarged, and bilateral swelling of adrenal glands was found. Histologically, multifocal proliferation of atypical cells was seen in the sinusoid or in the lumen of blood vessels throughout many organs, but there was little invasion of the parenchyma by these cells. From these findings, it was diagnosed as NAE. Immunohistochemically, these atypical cells showed positive reaction to the antileukocyte common antigen, anti-MB-1, LN-1, and LN-2, and negative reaction to the anti-Ki-1, anti-MT-1, anti-kappa, anti-lambda, and antifactor-VIII-related antigen. These findings showed that the atypical cells of NAE were of B lymphocyte origin.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
6/11. A case of sjogren's syndrome with severe anemia due to myelitis.An unusual case of sjogren's syndrome presenting with severe anemia as the predominant clinical feature is described. Histological examination of a bone marrow biopsy specimen demonstrated that the patient's anemia was caused by myelitis and vasculitis of the small intraosseous vessels. Our report might stimulate a more thorough investigation of bone marrow in patients with connective tissue diseases and anemia.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/11. Uveal involvement in systemic angiotropic large cell lymphoma. Microscopic and immunohistochemical studies.BACKGROUND: Angiotropic large cell lymphoma is a rare, generally fatal disease characterized by multifocal proliferation of neoplastic mononuclear cells within the lumens of blood vessels. methods: The authors report the clinical and immunohistochemical features of four patients with angiotropic large cell lymphoma. RESULTS: All patients presented with central nervous system symptoms, and three of the four had fever of unknown origin and anemia. The diagnosis was established by postmortem examination of the eyes in four patients and additionally by autopsy in three of the four patients. Two of the three autopsied patients had rare foci of extravascular involvement. One patient had erythrophagocytosis. Immunohistochemical stains on paraffin-embedded sections confirmed the diagnosis of lymphoma in all four patients. CONCLUSION: The results of this study support the B-cell lymphocyte origin of angiotropic large cell lymphoma.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/11. Zonary placenta.A primipara with an uncomplicated pregnancy was induced for labor. As uterine contractions commenced, an antepartum bleeding occurred, followed by fetal distress. An anemic fetus was delivered by cesarean section. The placenta was annular in shape with velamentous blood vessels, one of which was ruptured and sealed off by a fresh thrombus. A zonary or ring-shaped placenta is extremely rare: to our knowledge, this is the first case to be published.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/11. Dabska tumor developing within a preexisting vascular malformation.Malignant endovascular papillary angioendothelioma, first described by Dabska in 1969, is a rare vascular tumor that primarily affects children and is characterized by papillary proliferations of endothelial cells into vessel lumens. We report a case of this rare neoplasm in a boy with angiomatosis who developed kasabach-merritt syndrome. The tumor evolved as an ulcerated lesion superficially within a previous vascular malformation on his buttock. A review of the literature is presented.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/11. Endoscopic hemostasis of bleeding duodenal ulcer in a child with Henoch-Schonlein purpura.A 9-year-old boy with Henoch-Schonlein purpura had a duodenal ulcer. Endoscopic injection with pure ethanol was performed on a pulsating visible vessel in the third part of the duodenum, resulting in complete hemostasis. A bleeding ulcer, although rare, may be a serious gastrointestinal complication of Henoch-Schonlein purpura and may require aggressive intervention.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
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