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Pang YY, Andrew YWC. Hemoglobinuria during laparoscopic radiofrequency ablation of hepatocellular carcinoma. J Gastroenterol Hepatol 2006; 21:1355. [PMID: 16872328 DOI: 10.1111/j.1440-1746.2006.04125.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Sayar H, Dietl CA, Helms A, Rabinowitz I. Fragmentation hemolytic anemia 8 years after replacement of ascending aorta with a sutureless intraluminal graft. Am J Hematol 2006; 81:175-7. [PMID: 16493616 DOI: 10.1002/ajh.20513] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A 56-year-old man underwent replacement of the ascending aorta with a sutureless intraluminal graft, for a Stanford type A aortic dissection. Eight years after the operation, he developed gross hemoglobinuria, associated with an intravascular hemolytic anemia. Due to numerous schistocytes in the peripheral blood, the hemolysis was attributed to mechanical injury of the red blood cells at the site of the vascular graft. The patient's course was complicated by an infection of the aortic graft, which led to an urgent graft replacement. The hemolytic anemia resolved completely shortly after the reoperation. Physicians should consider this etiology in the differential diagnosis of fragmentation hemolytic anemia.
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Gbadoé AD, Kini-Caussi M, Koffi S, Traoré H, Atakouma DY, Tatagan-Agbi K, Assimadi JK. [Evolution of severe pediatric malaria in Togo between 2000 and 2002]. Med Mal Infect 2005; 36:52-4. [PMID: 16309874 DOI: 10.1016/j.medmal.2005.10.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2004] [Accepted: 10/17/2005] [Indexed: 11/20/2022]
Abstract
The aim of this study was to analyse the clinical and evolutive aspects of severe malaria in hospitalised children in 2000, 2001, and 2002 in Togo. The study included 361 children in the pediatrics department of Lomé-Tokoin University hospital. All them received a 10% dextrose infusion, then an infusion of quinine or intramuscular artemether. Malaria accounted for 4.37% of all hospitalizations. Children aged 1 to 5 years were more affected (69.53%). The most frequent clinical forms were anaemia (55.7%) followed by cerebral manifestations. The frequency of hemoglobinuria increased (17.2%) as well as renal failure (3%) compared to previous years. Thirty-five children died (9.7%). Most of them presented with anaemia, neurological manifestations, or respiratory distress. Neurological sequels were present in 2.2% of patients.
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Donepudi SK, Ahmed KA, Stocks RMS, Nelson D, Thompson JW. Aural involvement in loxoscelism: case report and literature review. Int J Pediatr Otorhinolaryngol 2005; 69:1559-61. [PMID: 15939487 DOI: 10.1016/j.ijporl.2005.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2005] [Accepted: 04/05/2005] [Indexed: 10/25/2022]
Abstract
An 11-year-old male presented with fever, rash, and a necrotic lesion on the lobule of the left ear. The lesion became tender and formed an eschar over 4 days. The patient developed leukocytosis, hemolytic anemia, and proteinuria, and was diagnosed with systemic loxoscelism from a brown recluse spider bite. He was managed with supportive therapy and improved in 4 days. Loxoscelism is a clinical diagnosis which should be suspected in an otherwise healthy patient with a necrotic wound, particulary in the endemic Southern and Midwestern United States. Physicians should be aware of this disease entity and its complications.
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Alidadi N, Bazargani TT, Mashhadi AG. Lamb hemoglobinuria due to nutritional hypophosphatemia. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2005; 46:947-8. [PMID: 16454390 PMCID: PMC2834509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Huang CC, Chen TW, Weng MC, Lee CL, Tseng HC, Huang MH. Effect of Glycemic Control on Electrophysiologic Changes of Diabetic Neuropathy in Type 2 Diabetic Patients. Kaohsiung J Med Sci 2005; 21:15-21. [PMID: 15754584 DOI: 10.1016/s1607-551x(09)70271-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Diabetic neuropathy is a common complication of diabetes mellitus. Effective blood glucose control retards changes in nerve conduction velocity in type 1 diabetes. This study examined the relationship between glycemic control and electrophysiologic changes in diabetic neuropathy in 57 type 2 diabetic patients. Nerve conduction in the peroneal motor nerve, tibial motor nerve, and sural nerve were measured at study entry and at follow-up 24+/-3.12 months later. Changes in individual nerves are expressed as a percentage change (PC) and overall electrophysiologic changes are expressed as the sum of individual PCs. The PCs for peroneal motor nerve velocity, tibial motor nerve velocity, and sural nerve velocity were all lower in patients with a mean HbA1c of 8.5% or less compared with those in patients with a mean HbA1c of more than 8.5%, and SPCV (sum of PC in velocity) was significantly inversely correlated with mean HbA1c. However, there was no significant difference in SPCV in subjects with or without hypertension, hypertriglyceridemia, or low high-density lipoprotein cholesterol concentration. In conclusion, hyperglycemia is the most important etiology for electrophysiologic progression in type 2 diabetic patients. Furthermore, a mean HbA1c of more than 8.5% will result in significant deterioration in electrophysiology.
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Tachibana K, Kobayashi S, Kojima T, Kaseno S, Kemmotsu O. [Pulmonary emboli in sclerotherapy for peripheral vascular malformations under general anesthesia; a report of two cases]. MASUI. THE JAPANESE JOURNAL OF ANESTHESIOLOGY 2004; 53:645-9. [PMID: 15242036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
Sclerotherapy with absolute ethanol and/or polidocanol is a well-established therapeutic modality for the treatment of peripheral vascular malformations, although systemic complications such as hemoglobinuria and pulmonary embolism could occur. We report two cases of pulmonary embolism associated with sclerotherapy for peripheral vascular malformations. Two patients, a 17-year-old man and a 17-year-old woman, undergoing absolute ethanol sclerotherapy for vascular malformations of the leg developed pulmonary embolism after injection of ethanol. Pulmonary embolism, suspected by the clinical symptoms such as hypoxia and hypocapnia, was confirmed by the pulmonary scintigraphy showing minimal pulmonary defects. Hemoglobinuria was also observed with injection of ethanol. Patients recovered rapidly with heparin and urokinase therapy. The review of perioperative complications with sclerotherapy for peripheral vascular malformations in our institution for past four years revealed that complications were observed in 18 out of 88 patients (20.5%), and in 32 out of 183 cases (17.5%). Major complications were hemoglobinuria, pulmonary embolism, shivering and delayed emergence from general anesthesia. We conclude that sclerotherapy for vascular malformations under general anesthesia is a risky procedure and this must be carefully managed with keen monitoring of Spo2 and Etco2.
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Akinci SB, Aykut T, Gozacan A, Kanbak M, Ozgen S, Aypar U. Perioperative neutropenia. Eur J Anaesthesiol 2004; 21:76-8. [PMID: 14768929 DOI: 10.1017/s026502150423112x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Petz LD. Review: evaluation of patients with immune hemolysis. Immunohematology 2004; 20:167-76. [PMID: 15373648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Talano JAM, Hillery CA, Gottschall JL, Baylerian DM, Scott JP. Delayed hemolytic transfusion reaction/hyperhemolysis syndrome in children with sickle cell disease. Pediatrics 2003; 111:e661-5. [PMID: 12777582 DOI: 10.1542/peds.111.6.e661] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Alloimmunization in patients with sickle cell disease (SCD) has a reported incidence of 5% to 36%. One complication of alloimmunization is delayed hemolytic transfusion reaction/hyperhemolysis (DHTR/H) syndrome, which has a reported incidence of 11%. In patients with SCD, clinical findings in DHTR/H syndrome occur approximately 1 week after the red blood cell (RBC) transfusion and include the onset of increased hemolysis associated with pain and profound anemia. The hemoglobin (Hb) often drops below pretransfusion levels. In many reported adult cases, the direct antiglobulin test (DAT) remains negative and no new alloantibody is detected as the cause for these transfusion reactions. To date, few pediatric cases have been reported with this phenomenon. The objective of this study was to describe the clinical and laboratory findings of a case series in children who had SCD and experienced a DHTR/H syndrome at our institution. METHODS An 11-year retrospective chart review of patients with discharge diagnosis of SCD and transfusion reaction was performed. DHTR/H syndrome was defined as the abrupt onset of signs and symptoms of accelerated hemolysis evidenced by an unexplained fall in Hb, elevated lactic dehydrogenase, elevated bilirubin above baseline, and hemoglobinuria, all occurring between 4 and 10 days after an RBC transfusion. Patient characteristics, time from transfusion, symptoms, reported DAT, new autoantibody or alloantibody formation, laboratory abnormalities, and complications were recorded. Patients with acute transfusion reactions were excluded. RESULTS We encountered 7 patients who developed 9 episodes of DHTR/H syndrome occurring 6 to 10 days after RBC transfusion. Each presented with fever and hemoglobinuria. All but 1 patient experienced pain initially ascribed to vaso-occlusive crisis. The DAT was positive in only 2 of the 9 episodes. The presenting Hb was lower than pretransfusion levels in 8 of the 9 events. Severe complications were observed after the onset of DHTR/H: acute chest syndrome, n = 3; pancreatitis, n = 1; congestive heart failure, n = 1; and acute renal failure, n = 1. CONCLUSIONS DHTR/H syndrome occurs in pediatric SCD patients, typically 1 week posttransfusion, and presents with back, leg, or abdominal pain; fever; and hemoglobinuria that may mimic pain crisis. Hb is often lower than it was at the time of original transfusion, suggesting the hemolysis of the patient's own RBCs in addition to hemolysis of the transfused RBCs; a negative DAT and reticulocytopenia are often present. Severe complications including acute chest syndrome, congestive heart failure, pancreatitis, and acute renal failure were associated with DHTR/H syndrome in our patients. DHTR/H in the pediatric sickle cell population is a serious and potentially life-threatening complication of RBC transfusion. It is important to avoid additional transfusions in these patients, if possible, because these may exacerbate the hemolysis and worsen the degree of anemia. DHTR/H syndrome must be included in the differential of a patient who has SCD and vaso-occlusive crisis who has recently had a transfusion.
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Tsui SL, Lee AKS, Lui SK, Poon RTP, Fan ST. Acute intraoperative hemolysis and hemoglobinuria during radiofrequency ablation of hepatocellular carcinoma. HEPATO-GASTROENTEROLOGY 2003; 50:526-9. [PMID: 12749264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Radiofrequency ablation is a safe and effective treatment for small primary or secondary liver tumors. Development of new probes has allowed the use of radiofrequency ablation for ablation of tumors > 5 cm in the liver. We present a case of acute intravascular hemolysis and hemoglobinuria during radiofrequency ablation of a large 8-cm hepatocellular carcinoma via laparotomy. The hemolysis was recognized during the operation by change of urine color, and prompt management was initiated to prevent acute renal failure. Literature search revealed that radiofrequency ablation can induce hemolysis in experimental setting, but this is the first clinical report of acute hemolysis during radiofrequency ablation for liver tumors.
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Salawu L, Durosinmi MA. Autoimmune haemolytic anaemia: pattern of presentation and management outcome in a Nigerian population: a ten-year experience. AFRICAN JOURNAL OF MEDICINE AND MEDICAL SCIENCES 2002; 31:97-100. [PMID: 12518900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Autoimmune haemolytic anaemia (AHA) is one of the commonest autoimmune disorders of man. It is characterised by the binding of anti-erythrocyte autoantibodies to red blood cells and destruction of the coated cells in the reticulo-endothelial system. Autoimnmune disorders are said to be rare in indigenous African population, probably due to the widespread infectious diseases, which impair host's T-cell immunity. This study is therefore aimed at investigating the pattern of presentation and management outcome of patients with AHA seen over a period of 10 years (June 1988 to May 1998) at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. We retrospectively analysed the records of patients with respect to the clinical, haematological, biochemical and serological features of AHA seen within the study period. Diagnosis was based on laboratory features of haemolytic anaemia and/or a positive direct anti-human globulin (Coombs') test after excluding other causes of haemolytic anaemia. Treatment protocol and outcome were noted in all cases. We identified 13 patients with AHA (7 females, 6 males) aged 6-70 (median, 42) years. Six (42%) had secondary AHA and the remaining 8 presented with primary (idiopathic) AHA. Laboratory evidence of haemolysis (bone marrow erythroid hyperplasia and hyperbilirubinaemia) was found in all cases, while the direct Coomb's test was positive in 10 (76.9%) cases. All the patients had moderate-severe anaemia within the course of the disease, requiring blood transfusion. Remission was induced with prednisolone in all except three cases with secondary AHA who died of the primary disease before AHA could be controlled. Follow-up period post-remission ranged between 1 and 78 months. However, 2 (20%) are still being followed-up till the time of this report. This study agrees with the view that autoimmune disorders are not common in Nigerians, as documented for other Africans. It also shows that steroid therapy (prednisolone) is quite effective, especially, in idiopathic AHA, and that red cell transfusion could be useful in life-threatening anaemia.
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MESH Headings
- Adolescent
- Adult
- Aged
- Anemia, Hemolytic, Autoimmune/blood
- Anemia, Hemolytic, Autoimmune/diagnosis
- Anemia, Hemolytic, Autoimmune/epidemiology
- Anemia, Hemolytic, Autoimmune/etiology
- Anemia, Hemolytic, Autoimmune/therapy
- Anti-Inflammatory Agents/therapeutic use
- Bilirubin/blood
- Child
- Coombs Test
- Erythrocyte Transfusion
- Female
- Fever/etiology
- Hematocrit
- Hemoglobinuria/etiology
- Hospitals, University
- Humans
- Jaundice/etiology
- Leukocyte Count
- Male
- Middle Aged
- Nigeria/epidemiology
- Prednisolone/therapeutic use
- Prevalence
- Remission Induction/methods
- Retrospective Studies
- Risk Factors
- Severity of Illness Index
- Splenomegaly/etiology
- Treatment Outcome
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Eda K, Ohtsuka S, Seo Y, Yamada S, Ishiyama M, Miyamoto T, Horigome H, Yamaguchi I. Conservative treatment of hemolytic complication following coil embolization in two adult cases of patent ductus arteriosus. JAPANESE CIRCULATION JOURNAL 2001; 65:834-6. [PMID: 11548885 DOI: 10.1253/jcj.65.834] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Two adult cases of relatively large patent ductus arteriosus (PDA) were treated by coil embolization, but were complicated by hemolysis that was successfully managed by medical treatment. Case 1 was a 67-year-old woman and Case 2 was a 71-year-old woman with a PDA of minimal diameter of 5.3 mm and 5.5 mm, respectively. The approach was via the pulmonary artery and 2 coils were delivered simultaneously into the ductus, known as the 'kissing coil technique'. Although immediately after the procedure only a small residual shunt was revealed by aortogram, hemolysis occurred for several hours after the procedure in both cases. A hemolytic complication usually needs additional coil embolization or surgical treatment, but in these 2 cases it was successfully treated by haptoglobin infusion to prevent nephropathy and by antiplasmin infusion to promote thrombus formation. Hemolytic complications of coil embolization of PDA can managed by medication when the residual shunt is minimal and the degree of hemolysis is mild.
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Abstract
OBJECTIVES To retrospectively evaluate the safety and efficacy of percutaneous sclerotherapy with polidocanol in 9 patients with venous malformations of the glans penis. Vascular malformations of the external genitalia can be aesthetically and functionally disabling. These lesions are rare and their treatment is still controversial. METHODS Seven patients were asymptomatic, seeking advice for cosmetic reasons, and 2 patients had experienced several bleeding episodes during sexual intercourse. In all patients, Doppler ultrasound scanning was performed before treatment. All patients underwent direct intralesional injection of polidocanol. The concentration of the sclerosant varied from 1% to 3%, and the volume of the solution varied from 2 to 4 mL per injection. Four patients required multiple sclerotherapeutic sessions. RESULTS All patients experienced marked swelling after the injection and three developed cutaneous blistering. Neither cutaneous necrosis nor early or late major complications occurred. At a mean follow-up of 35.1 months, 7 patients were cured and 2 had marked improvement. No patients presented with signs of recurrence, and the outcome was overall cosmetically successful. CONCLUSIONS Sclerotherapy with polidocanol is a well-tolerated, safe, and effective treatment for venous malformations of the penis. In our opinion, it can be considered the treatment of choice.
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Manfredini R, La Cecilia O, Ughi G, Kuwornu H, Bressan S, Regoli F, Orzincolo C, Daniele C, Gallerani M. Renal infarction: an uncommon mimic presenting with flank pain. Am J Emerg Med 2000; 18:325-7. [PMID: 10830691 DOI: 10.1016/s0735-6757(00)90129-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
A 39-year-old woman arrived to the emergency department complaining of a constant, progressive, left flank pain, with no beneficial effect from spasmolytic and nonsteroidal antiinflammatory drugs. Two years before, she suffered another episode of right flank pain and stranguria, but instrumental examinations (ultrasonography, urography) remained negative. Besides a mild tenderness in the left flank, physical examination was normal. Blood chemistry panel showed leukocytosis (17.2 x 10(3) mL, neutrophils 82.8%) and a slight increase of serum lactate dehydrogenase (LDH) (543 U/L versus 230 to 460 U/L). Urinanalysis showed a slight hemoglobinuria (0.5 mg/dL), and sediment contained some red cells and leukocytes. Diagnostic examinations (ultrasonography, computed tomography) showed a left renal nonhomogeneous space-occupying lesion, orientative for renal malignancy. She was transferred to the urology department and operated. Both intraoperatory and histological diagnosis was ischemic infarction and, after exclusion of all possible underlying causes, final diagnosis was idiopathic renal infarction. Diagnostic procedures and literature reports are discussed.
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Beutler E, Luzzatto L. Hemolytic anemia. Semin Hematol 1999; 36:38-47. [PMID: 10595753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
We entered the 20th century with only meager understanding of the erythrocyte. We leave this century with a relatively detailed understanding of the metabolism of the erythrocyte, the structure of its membrane, and the basis of genetic disorders that lead to its early demise in hemolytic anemia. Among the immune hemolytic disorders, the conquest of Rh hemolytic disease is one of the important clinical achievements of this century. Hereditary disorders of the membrane generally cause shape changes, such as spherocytosis or ovalocytosis. Paroxysmal nocturnal hemoglobinuria is the result of an acquired (somatic) mutation of PIG-A, an X-linked component of the glycosylphosphatidylinositol (GPI) anchor. Red cell enzyme deficiencies cause hereditary nonspherocytic hemolytic anemia. The mutations that cause the more common of these deficiencies are now well understood at the DNA level. Although much progress has been made, much is still to be learned. In particular, management of both acquired and hereditary hemolytic anemias is still very unsatisfactory. Often the only decision that can be made is whether to perform a splenectomy. In the future it is to be hoped that the knowledge that has been gained about these disorders in this century will make available better therapy to our patients in the next.
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Uzun O, Veldtman GR, Dickinson DF, Parsons JM, Blackburn ME, Gibbs JL. Haemolysis following implantation of duct occlusion coils. Heart 1999; 81:160-1. [PMID: 9922351 PMCID: PMC1728949 DOI: 10.1136/hrt.81.2.160] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe the incidence and management of haemolysis after transcatheter coil occlusion of the arterial duct. DESIGN Prospective clinical and echocardiographic follow up of patients who have undergone implantation of the Cook detachable duct occlusion coil. SETTING Tertiary paediatric cardiac centre. PATIENTS Five cases of haemolysis (two girls aged 6 and 11 months; three boys aged 6, 17, and 14 months) from a series of 137 duct coil implantations. MAIN OUTCOME MEASURES The occurrence of clinically significant haemolysis after implantation of duct occlusion coils and resolution of haematuria after completion of duct occlusion. RESULTS Haemolysis was detected in five of 137 procedures following implantation of Cook detachable duct coils. Four patients became symptomatic 12 hours after the procedure but in one haemolysis was detected three months later. Resolution of ongoing haemolysis was achieved within 48 hours of detection with further coil implantations, but haematuria persisted for up to 10 days. In one patient the extensive destruction of erythrocytes resulted in acute renal failure requiring peritoneal dialysis. CONCLUSIONS Haemolysis is an important complication after duct coil implantation. It occurred in 3.6% of 137 procedures in this series and is most likely to occur in young patients with relatively large ducts. Further coil implantation to occlude the duct completely is not only successful but technically relatively straightforward and should be undertaken early if major complications such as severe anaemia and renal failure are to be avoided.
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Mortensen S. Unexplained haemoglobinuria may have been haematuria. BMJ (CLINICAL RESEARCH ED.) 1999; 318:192. [PMID: 9888925 PMCID: PMC1114671 DOI: 10.1136/bmj.318.7177.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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SCHMID R, MAHLER R. Chronic progressive myopathy with myoglobinuria: demonstration of a glycogenolytic defect in the muscle. J Clin Invest 1998; 38:2044-58. [PMID: 14442994 PMCID: PMC441792 DOI: 10.1172/jci103983] [Citation(s) in RCA: 231] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kitagawa H, Kitoh K, Ohba Y, Kuwahara Y, Iwasaki T, Sasaki Y. Comparison of laboratory test results before and after surgical removal of heartworms in dogs with vena caval syndrome. J Am Vet Med Assoc 1998; 213:1134-6. [PMID: 9787379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To compare results of laboratory tests in dogs with vena caval syndrome before and after surgical removal of heartworms. DESIGN Longitudinal uncontrolled clinical trial. ANIMALS 51 dogs with vena caval syndrome. PROCEDURE Heartworms were removed from the area of the tricuspid valve and pulmonary arteries via venotomy and by use of flexible alligator forceps. Blood samples were obtained before and 10 days after removal of heartworms. Red and white blood cell counts were determined, using an automated cell counter. Biochemical tests were performed, using a dry chemical method. RESULTS 45 dogs survived the procedure, and 6 died or were euthanatized after surgical treatment. After surgery, RBC count and total protein, albumin, calcium, and sodium concentrations increased, and total bilirubin, ammonia, BUN, creatinine, uric acid, and potassium concentrations decreased in dogs that survived. Creatine kinase, L-lactate dehydrogenase, and amylase activities decreased, whereas alkaline phosphatase and gamma-glutamyltransferase activities and total cholesterol concentration increased. Alanine transaminase activity decreased in 27 dogs but increased in 3 dogs. Changes in test results in dogs that did not survive. Significant differences were found in RBC count, gamma-glutamyltransferase activity, and total protein, total cholesterol, BUN, and total bilirubin concentrations before and after removal of heartworms. CLINICAL IMPLICATIONS Hepatic and renal functions improve rapidly after surgical removal of heartworms, presumably because general and pulmonary circulation is normalized. However, cholestasis may develop, and dogs that survive may need additional treatment to preserve hepatic function.
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Schermerhorn T, McNamara PS, Dykes NL, Toll J. Cullen's sign and haemoglobinuria as presenting signs of retroperitoneal haemorrhage in a dog. J Small Anim Pract 1998; 39:490-4. [PMID: 9816573 DOI: 10.1111/j.1748-5827.1998.tb03685.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Haemoglobinuria and periumbilical discoloration (also known as Cullen's sign) are clinical signs uncommonly reported in veterinary patients. This report describes a case of retroperitoneal haemorrhage in a dog, associated with haemoglobinuria and Cullen's sign. To the authors' knowledge, these clinical signs have not previously been reported singularly or in combination with retroperitoneal haemorrhage in dogs. A neutered male Shetland sheepdog, which was presented for haematuria, also had an abdominal mass, abdominal pain and a large area of periumbilical discoloration. Laboratory studies determined that haemoglobinuria was the cause of the red-coloured urine. Abdominal radiographs suggested a splenic mass and a coeliotomy was performed. During the induction and throughout the anaesthetic period the dog was hypertensive and a large haematoma originating from the right retroperitoneal space was identified at surgery. The cause of the haemorrhage was uncertain but a ruptured phaeochromocytoma was thought possible on the basis of the persistent hypertension and the location of the haemorrhage.
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Abstract
Parturient haemoglobinuria is a disease of economic importance in buffalo rearing countries in general and in India, Pakistan and Egypt in particular. This study reviews the information on aetiology, epidemiology, clinical aspects and treatment of parturient haemoglobinuria in buffaloes. The body of literature reviewed suggests that phosphorus deficiency in the diet of affected animals plays a major role in causing this disease, although the precise mechanism involved is complex. The possible factors involved and their interplay, plus the clinical picture of affected animals and the results of different preventive and therapeutic regimes are discussed. The study also identifies areas for further research.
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Grossman LD. Updating the insulin lispro file. CMAJ 1998; 158:1132-3. [PMID: 9597962 PMCID: PMC1229267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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