1/6. pituitary apoplexy in a patient with acute myeloid leukemia and thrombocytopenia.We describe a 72-year-old woman with a history of acute myeloid leukemia who developed pituitary apoplexy associated with thrombocytopenia secondary to chemotherapy. She presented with new onset severe headache, nausea, vomiting and blurred vision. Initial physical examination was unremarkable. CT scan of the head was initially negative. Upon admission for further work up, She developed a high-grade fever, hypotension and obtundation. Subsequent physical examination revealed bitemporal visual fields defects and decreased visual acuity. Repeat imaging of head revealed a hemorrhagic pituitary mass compressing the optic chiasm. Laboratory results were compatible with the diagnosis of pan-hypopituitary syndrome. She received high dose steroids and was transferred for transnasal sphenoidotomy decompression surgery. The visual defects improved postoperatively. A literature review of pituitary apoplexy is presented. pituitary apoplexy secondary to thrombocytopenia has never been reported.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Hematologic and molecular spontaneous remission following sepsis in acute monoblastic leukemia with translocation (9;11): a case report and review of the literature.Spontaneous remission in patients with acute myeloid leukemia (AML) is a rarely reported phenomenon of usually short duration. The etiology remains unclear, but an association with preceding blood transfusions or bacterial infections has been reported. Triggered immune responses are suggested to play a potential role in the development of spontaneous remission. Acute monocytic leukemia was diagnosed in a 61-yr-old male patient. cytogenetic analysis revealed a sole translocation (9;11) (q22;q23) and RT-PCR the MLL/AF9 fusion gene. As a result of the patient's reduced performance status and septic condition, cytostatic therapy was withheld. No microorganisms could be detected. Hematologic and molecular remission occurred after initiating antibiotic therapy without any cytostatic treatment; 29 months after the initial diagnosis, he is in complete remission, and excellent physical condition. Our report includes a review of the literature since 1985, reporting cases of patients with AML and spontaneous remission together with informative cytogenetics. Balanced translocations such as in core binding factor (CBF) leukemias appear somewhat overrepresented. We speculate that AML-specific T cells might be relevant for induction of spontaneous remission and need to be further investigated.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
3/6. breast nodules as the initial site of relapse in childhood leukemia.Two children with acute monoblastic leukemia in remission developed breast nodules that were the initial sites of disease relapse. Shortly after the appearance of disease in this site, the children developed marrow recurrence and, despite additional treatment, rapidly deteriorated and died from pancytopenia-related complications. The importance of careful breast examination is stressed as part of the surveillance physical examination for children with monoblastic leukemia.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
4/6. A case of turner syndrome with the karyotype of 45,X/46,X,i(Xq) associated with acute monocytic leukemia.An infertile 37-year-old woman was diagnosed as having acute monocytic leukemia (AMoL) (FAB classification; M5b). In addition, a diagnosis of infertile turner syndrome was made, based on the presence of the ovarian dysplasia, abnormal physical features (short stature, lack of pubic hair, shield-like chest, etc.), and low urinary estrogen excretion with high plasma gonadotropin level. Karyotypes in the peripheral blood and bone marrow cells were mosaic 45,X and 46,X,i(Xq): isochromosome Xq, which were consistent with infertile turner syndrome. No further chromosomal abnormalities were found during the course of her treatment for leukemia. This is the first report of the combination of turner syndrome and AMoL. However, this patient did not have any of the other autosomal chromosomal abnormalities which are common in acute non-lymphocytic leukemias.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
5/6. Spontaneous remission of presumed congenital acute nonlymphoblastic leukemia (ANLL) in a karyotypically normal neonate.A 3-hour-old phenotypically normal girl was transferred to Children's Hospital Medical Center because of skin nodules, hepatosplenomegaly, and marked leukocytosis. The predominant cells in the blood, bone marrow, and dermis were monoblasts consistent with congenital leukemia. Known causes of leukemoid reactions were excluded. The infant received two double-volume exchange transfusions but no chemotherapy. As the white blood cell counts decreased, the monocytic cells became more mature, suggesting that the monoblasts had the ability to differentiate. The proliferative capacity of the marrow appeared to be normal as determined by the ability of marrow cells to form colonies in soft agar. Chromosomal analysis of bone marrow blasts including trypsin--Giemsa banding was normal. Three weeks after birth the patient's CBC and physical examination were normal, and the bone marrow was normal by 4 months of age. The patient has remained in remission for over 3 years.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/6. Chemotherapy for acute monoblastic leukaemia.This study describes the care given to a 64-year-old man in whom acute monoblastic leukaemia had been newly diagnosed. The patient consented to enrollment in a randomised clinical drug trial, and the author's role in care related to this decision is discussed. nursing interventions, detailing physical, psychological and social aspects of care, are given with their rationales.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |