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Jaenke CM, Moore SR, Miller MD, Garg A. A Case of Cutaneous Vasculitis in the Setting of Systemic Lupus Erythematosus and Cocaine Use. J Investig Med High Impact Case Rep 2023; 11:23247096231176215. [PMID: 37209041 DOI: 10.1177/23247096231176215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
Cocaine, one of most prevalent illicit substances in the United States, affects a multitude of organ systems and precedes numerous negative health outcomes. Many of the consequences of cocaine are linked to induction of vasoconstriction. For this reason, cocaine users are placed at considerable risk of ischemic stroke, myocardial infarction, and cardiac arrhythmias. Furthermore, a prominent contaminant, levamisole, has been widely implicated in predisposing individuals to developing or exacerbating cutaneous vasculitides. This report details a 31-year-old woman with acute, localized necrotic skin lesions after cocaine use. Her clinical picture was complicated by a 17-year history of systemic lupus erythematosus (SLE) and Raynaud's phenomenon. This case examines the challenge of forming a differential diagnosis, initiating an appropriate workup, and interpreting serologic-based and immunologic-based studies to differentiate between SLE and drug-based etiologies of skin necrosis. Finally, we discuss appropriate treatment plans to mitigate symptoms and reduce future instances of drug-induced vasculitis.
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Affiliation(s)
| | - Sara R Moore
- The University of Toledo Medical Center, OH, USA
| | | | - Anu Garg
- The University of Toledo Medical Center, OH, USA
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2
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Immune-Related Uncommon Adverse Events in Patients with Cancer Treated with Immunotherapy. Diagnostics (Basel) 2022; 12:diagnostics12092091. [PMID: 36140493 PMCID: PMC9498261 DOI: 10.3390/diagnostics12092091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 11/16/2022] Open
Abstract
Immunotherapy has dramatically changed the therapeutic landscape of oncology, and has become standard of care in multiple cancer types in front or late lines of therapy, with some longstanding responses and outstanding results. Notwithstanding, its use has brought a totally unique spectrum of adverse events, characterized by a myriad of diverse manifestations affecting nearly every organ and system of the body, including the endocrine, nervous, cardiac, respiratory and gastrointestinal systems. Uncommon adverse events, defined as those occurring in less than 1% of patients, comprise an even more heterogeneous group of diseases that are being seen more recurrently as the use of immune check-point inhibitors increases and indications spread in different tumor types and stages. Here, we comprehensively review some uncommon, but exceedingly important, immune-related adverse events, with special emphasis in the clinical approach and diagnostic workup, aiming to reunite the evidence published previously, allowing an increase in awareness and knowledge from all specialists implicated in the diagnosis, treatment, and care of cancer patients treated with immunotherapy.
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Litao MKS, Alvarez AG, Shah B. Pre-treatment Neutropenia in Children and Adolescents with Autoimmune Hyperthyroidism. J Clin Res Pediatr Endocrinol 2021; 13:263-268. [PMID: 33261249 PMCID: PMC8388046 DOI: 10.4274/jcrpe.galenos.2020.2020.0184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Neutropenia can occur in untreated autoimmune hyperthyroidism (AIH) or in association with treatment with the anti-thyroid drug, methimazole (MMI). Starting MMI in children and adolescents with AIH and pre-existing neutropenia could thus be worrisome. The aim was to describe the prevalence of neutropenia in pediatric AIH, prior to antithyroid drug therapy and to assess the effect of antithyroid drugs on neutrophil count. METHODS Patients with AIH attending a pediatric endocrinology clinic were retrospectively reviewed. Absolute neutrophil count (ANC) data at presentation and during anti-thyroid treatment for up to 24 weeks was collected. AIH was defined as elevated free thyroxine (fT4) or free tri-iodothyronine (fT3), suppressed thyroid stimulating hormone, and positive thyroid autoantibodies. Neutropenia was defined as ANC <1500 cells/μL. RESULTS Thirty-one patients (71% female) were included with a median interquartile range (IQR) age of 14.71 (11.89-17.10) years. Neither fT4 nor fT3 levels correlated with ANC at presentation (rs=0.22, p=0.24 and rs=0.13, p=0.54, respectively). 26/31 (84%) had normal baseline ANC. None developed neutropenia with thionamides. 5/31 (16%) had baseline neutropenia (median ANC 1,200/μL; IQR 874-1200). Four of these five started MMI at diagnosis while one was started on propranolol only but MMI was started one week later. All five normalized ANC within 24 weeks. CONCLUSION In this cohort, 16% of AIH patients had neutropenia at presentation, but this resolved in the short term and did not worsen with thionamides. Thionamides may be used with caution in these patients with close monitoring of blood counts.
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Affiliation(s)
- Melissa Kaori S. Litao
- New York University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, New York, USA
| | - Ana Gutierrez Alvarez
- New York University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, New York, USA
| | - Bina Shah
- New York University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, New York, USA,* Address for Correspondence: New York University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, New York, USA E-mail:
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Lintel H, Saffaf M. Neutropenia, Thrombocytopenia, and Eosinophilia: An Unusual Triad in a Patient on Long-Term Vancomycin Therapy. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e931647. [PMID: 34101721 PMCID: PMC8197443 DOI: 10.12659/ajcr.931647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Patient: Female, 46-year-old Final Diagnosis: Adverse drug reaction • epidural abscess Symptoms: Eosinophilia • neutropenia • thrombocytopenia Medication: — Clinical Procedure: — Specialty: General and Internal Medicine
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Affiliation(s)
- Hendrik Lintel
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Mohammad Saffaf
- School of Medicine, Saint Louis University, Saint Louis, MO, USA
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Pattanaik S, Jain A, Ahluwalia J. Evolving Role of Pharmacogenetic Biomarkers to Predict Drug-Induced Hematological Disorders. Ther Drug Monit 2021; 43:201-220. [PMID: 33235023 DOI: 10.1097/ftd.0000000000000842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/21/2020] [Indexed: 11/26/2022]
Abstract
ABSTRACT Drug-induced hematological disorders constitute up to 30% of all blood dyscrasias seen in the clinic. Hematologic toxicity from drugs may range from life-threatening marrow aplasia, agranulocytosis, hemolysis, thrombosis to mild leukopenia, and thrombocytopenia. Pathophysiologic mechanisms underlying these disorders vary from an extension of the pharmacological effect of the drug to idiosyncratic and immune-mediated reactions. Predicting these reactions is often difficult, and this makes clinical decision-making challenging. Evidence supporting the role of pharmacogenomics in the management of these disorders in clinical practice is rapidly evolving. Despite the Clinical Pharmacology Implementation Consortium and Pharmacogenomics Knowledge Base recommendations, few tests have been incorporated into routine practice. This review aims to provide a comprehensive summary of the various drugs which are implicated for the hematological adverse events, their underlying mechanisms, and the current evidence and practical recommendations to incorporate pharmacogenomic testing in clinical care for predicting these disorders.
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Affiliation(s)
| | - Arihant Jain
- Internal Medicine, Hematology and Bone Marrow Transplantation, and
| | - Jasmina Ahluwalia
- Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Boivin G, Ancey PB, Vuillefroy de Silly R, Kalambaden P, Contat C, Petit B, Ollivier J, Bourhis J, Meylan E, Vozenin MC. Anti-Ly6G binding and trafficking mediate positive neutrophil selection to unleash the anti-tumor efficacy of radiation therapy. Oncoimmunology 2021; 10:1876597. [PMID: 33628622 PMCID: PMC7889163 DOI: 10.1080/2162402x.2021.1876597] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/05/2022] Open
Abstract
The anti-Ly6G antibody is used to deplete Ly6Gpos neutrophils and study their role in diverse pathologies. However, depletion is never absolute, as Ly6Glow neutrophils resistant to depletion rapidly emerge. Studying the functionality of these residual neutrophils is necessary to interpret anti-Ly6G-based experimental designs. In vitro, we found anti-Ly6G binding induced Ly6G internalization, surface Ly6G paucity, and primed the oxidative burst of neutrophils upon TNF α co-stimulation. In vivo, we found neutrophils resistant to anti-Ly6G depletion exhibited anti-neutrophil-cytoplasmic-antibodies. In the pre-clinical KrasLox-STOP-Lox-G12D/WT; Trp53Flox/Flox mouse lung tumor model, abnormal neutrophil accumulation and aging was accompanied with an N2-like SiglecFpos polarization and ly6g downregulation. Consequently, SiglecFpos neutrophils exposed to anti-Ly6G reverted to Ly6Glow and were resistant to depletion. Noting that anti-Ly6G mediated neutrophil depletion alone had no anti-tumor effect, we found a long-lasting rate of tumor regression (50%) by combining anti-Ly6G with radiation-therapy, in this model reputed to be refractory to standard anticancer therapies. Mechanistically, anti-Ly6G regulated neutrophil aging while radiation-therapy enhanced the homing of anti-Ly6G-boundSiglecFneg neutrophils to tumors. This anti-tumor effect was recapitulated by G-CSF administration prior to RT and abrogated with an anti-TNFα antibody co-administration. In summary, we report that incomplete depletion of neutrophils using targeted antibodies can intrinsically promote their oxidative activity. This effect depends on antigen/antibody trafficking and can be harnessed locally using select delivery of radiation-therapy to impair tumor progression. This underutilized aspect of immune physiology may be adapted to expand the scope of neutrophil-related research.
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Affiliation(s)
- Gaël Boivin
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Life Sciences Ecole Polytechnique Fédérale De, Lausanne, Swiss Institute for Experimental Cancer Research, Lausanne, Switzerland
- Radio-Oncology Service, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Benoit Ancey
- School of Life Sciences Ecole Polytechnique Fédérale De, Lausanne, Swiss Institute for Experimental Cancer Research, Lausanne, Switzerland
| | | | - Pradeep Kalambaden
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Caroline Contat
- School of Life Sciences Ecole Polytechnique Fédérale De, Lausanne, Swiss Institute for Experimental Cancer Research, Lausanne, Switzerland
| | - Benoit Petit
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Radio-Oncology Service, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonathan Ollivier
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Radio-Oncology Service, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jean Bourhis
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Radio-Oncology Service, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Etienne Meylan
- School of Life Sciences Ecole Polytechnique Fédérale De, Lausanne, Swiss Institute for Experimental Cancer Research, Lausanne, Switzerland
| | - Marie-Catherine Vozenin
- Radio-Oncology Laboratory, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Radio-Oncology Service, Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Qin Y, Wang Y, Wu Y, Feng M, Zhao X, Gao C, Guo H, Luo J. Double-negative T cells are absolutely elevated in patients with antineutrophil cytoplasmic autoantibody-associated vasculitis. Mol Immunol 2021; 132:250-259. [PMID: 33518366 DOI: 10.1016/j.molimm.2021.01.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/03/2021] [Accepted: 01/16/2021] [Indexed: 10/22/2022]
Abstract
CD3+CD4-CD8- [double-negative (DN)] T cells play vital roles in the pathogenesis of autoimmune disorders. In this study, we investigated the exact level of DN T cells in patients with antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). Forty patients with active AAV and 19 healthy controls (HCs) were enrolled in this study. Peripheral mononuclear cells were characterised phenotypically via flow cytometry. The potential clinical value of DN T cells was then assessed by the receiver operating characteristic (ROC) curves. The percentage (p < 0.001) and absolute number (p = 0.028) of DN T cells were found to be significantly higher in patients with AAV than in HCs. Relative to HCs, a lower percentage of DN T cells from patients with AAV was of the CD62L+CD45RO+ phenotype (p = 0.024), a higher percentage of these cells was of the CD62L-CD45RO- phenotype (p = 0.043). Patients with AAV had increased percentages of DN T cells expressing interferon (IFN)-γ (p = 0.032), interleukin (IL)-4 (p = 0.039) and IL-17 (p = 0.042). Furthermore, the percentages of IL-17-producing CD4+ T cells and IFN-γ-producing CD8+ T cells were significantly higher in patients with AAV than in HCs (p = 0.014, p = 0.008). Compared with the CD4+ and CD8+ T-cell subsets, DN T cells had the highest fractions of intracellular IL-17 in HCs and patients with AAV (both p < 0.001). In patients with AAV and renal damage, the percentage of DN T cells was expanded relative to that in patients without renal damage (p = 0.016). In addition, conventional methylprednisolone effectively reduced the percentage and overall number of DN T cells in patients with AAV (p = 0.028, p = 0.007). DN T cells represent a T-lymphocyte subset that produces inflammatory cytokines (IFN-γ, IL-4 and IL-17) and is absolutely elevated in patients with AAV. Additional investigations are required to determine their precise role in patients with AAV.
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Affiliation(s)
- Yan Qin
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Yanlin Wang
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Yanyao Wu
- The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Min Feng
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Xiangcong Zhao
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China
| | - Chong Gao
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hui Guo
- Division of Nephrology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China; Division of Nephrology, Department of Medicine, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, Guangdong, 518005, China.
| | - Jing Luo
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, 030001, China.
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8
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Wang Y, Zhang S, Zhang N, Feng M, Liang Z, Zhao X, Gao C, Qin Y, Wu Y, Liu G, Zhao J, Guo H, Luo J. Reduced activated regulatory T cells and imbalance of Th17/activated Treg cells marks renal involvement in ANCA-associated vasculitis. Mol Immunol 2019; 118:19-29. [PMID: 31837507 DOI: 10.1016/j.molimm.2019.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 11/01/2019] [Accepted: 11/25/2019] [Indexed: 12/11/2022]
Abstract
The role of naturally occurring regulatory T cells (Treg) in the control of the immune tolerance of ANCA-associated vasculitis (AAV) has not been well defined. Therefore, we separate the phenotypically heterogeneous Treg cells into different subsets based on the expression of FOXP3 and CD45RA during AAV pathogenesis. Fifty-four AAV patients (38 patients with renal involvement) and 19 healthy controls (HCs) were enrolled in this study. Levels of CD4+T cell subsets and cytokines were detected by flow cytometry. Treg immunesuppression capacity was measured in co-culture experiments. The diagnostic value for Treg subsets was evaluated by the areas under the receiver operating characteristic curves (AUC). Patients with AAV had lower percentages and numbers of activated Treg cells (aTreg, P = 0.044, P = 0.002), while higher levels of total Treg cells (P = 0.001, P = 0.026) with diminished immunosuppression capacity. The proportions of effector memory T-cell subpopulation (P < 0.001) were increased in AAV patients. Interestingly, the AUC of the aTreg improved significantly the diagnostic potential of AAV. Furthermore, the ratio of Th17/aTreg was significantly increased in active and renal vasculitis patient and positive correlation between Th17/Treg subset ratio and creatinine or BUN. In addition, we found that cytokine IL-2 and IL-4 exhibited a downward while IL-6, IL-10, TNF-α, IFN-γ and IL-17A trend upward in AAV patients. Increase in total Treg levels, along with functional deficiency, and decrease in aTreg cells constitute potential novel biomarkers for AAV. And the ratio of Th17/aTreg might serve as an important tool to recognize and monitor AAV patients with renal involvement and disease remission.
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Affiliation(s)
- Yanlin Wang
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Shulan Zhang
- Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing 100730, China
| | - Na Zhang
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Min Feng
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhaojun Liang
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiangcong Zhao
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Chong Gao
- Department of Pathology,Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yan Qin
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yanyao Wu
- Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Guangying Liu
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jinfang Zhao
- Department of Medical Statistics, Shanxi Medical University, Taiyuan, China
| | - Hui Guo
- Division of Nephrology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China; Division of Nephrology, Department of Medicine, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, Guangdong 518005, China.
| | - Jing Luo
- Division of Rheumatology, Department of Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China.
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Michot JM, Lazarovici J, Tieu A, Champiat S, Voisin AL, Ebbo M, Godeau B, Michel M, Ribrag V, Lambotte O. Haematological immune-related adverse events with immune checkpoint inhibitors, how to manage? Eur J Cancer 2019; 122:72-90. [PMID: 31634647 DOI: 10.1016/j.ejca.2019.07.014] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 01/06/2023]
Abstract
Immune checkpoint inhibitors (ICIs) are changing the treatments of many patients with cancer. These immunotherapies are generally better tolerated than chemotherapy, and their adverse events are immune-related mimicking autoimmune or inflammatory conditions. Although these immune-related adverse events mainly affect the skin, endocrine glands, digestive tract, joints, liver or lungs, all the organs can be theoretically affected, and the haematopoietic system is not spared. This review of the literature will focus on the haematological immune-related adverse events (Haem-irAEs). By reviewing the largest clinical trials of ICIs, we estimate the frequency of Haem-irAEs at 3.6% for all grades and 0.7% for grades III-IV. Frequency of Haem-irAEs of all grades was found to be higher with anti-programmed cell death 1 (4.1%) or anti-programmed cell death ligand 1 (4.7%) than with anti-cytotoxic T-lymphocyte-associated protein 4 (0.5%) (p < 0.0001). From the 63 cases with Haem-irAEs reported in the literature, the mean time to the onset was found to be 10 weeks after ICI initiation, and the large range for occurrence (1-84 weeks) and the regular incidence suggest that Haem-irAEs could occur at any time after ICI therapy. Among the 63 reported cases with Haem-irAEs, the distribution was immune thrombocytopenia (n = 18, 29%), pancytopenia or immune aplastic anaemia (n = 12, 19%), neutropenia (n = 11, 17%), haemolytic anaemia (n = 10, 16%), cytokine release syndrome with haemophagocytic syndrome (n = 7, 11%) and other Haem-irAEs including bicytopenia or pure red cell aplasia (n = 5, 8%). Haem-irAEs are generally highly severe adverse reactions with a mortality rate of Haem-irAEs reported to be 14% (9 deaths among the 63 cases reported). The more severe and life-threatening Haem-irAEs were both cytokine release syndrome with haemophagocytic syndrome and pancytopenia or aplastic anaemia. Haem-irAEs induced by ICIs are potentially life-threatening. By discussing their pathophysiological aspects and clinical picture, we propose in this review clinical guidelines for management.
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Affiliation(s)
- J M Michot
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, F-94805, France; Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Médecine Interne et Immunologie Clinique, Le Kremlin-Bicêtre, F-94275, France.
| | - J Lazarovici
- Gustave Roussy, Université Paris-Saclay, Département D'Hématologie, Villejuif, F-94805, France
| | - A Tieu
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Médecine Interne et Immunologie Clinique, Le Kremlin-Bicêtre, F-94275, France
| | - S Champiat
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, F-94805, France
| | - A L Voisin
- Gustave Roussy, Université Paris-Saclay, Unité de Pharmacovigilance, Villejuif, F-94805, France
| | - M Ebbo
- Assistance Publique - Hôpitaux de Marseille, Hôpital de La Timone, Médecine Interne, Marseille, F-13005, France
| | - B Godeau
- Assistance Publique - Hôpitaux de Paris, Hôpital Henri Mondor, Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de L'Adulte, Université Paris-Est Créteil, Créteil, F-94010, France
| | - M Michel
- Assistance Publique - Hôpitaux de Paris, Hôpital Henri Mondor, Médecine Interne, Centre de Référence des Cytopénies Auto-immunes de L'Adulte, Université Paris-Est Créteil, Créteil, F-94010, France
| | - V Ribrag
- Gustave Roussy, Université Paris-Saclay, Département des Innovations Thérapeutiques et Essais Précoces, Villejuif, F-94805, France; Gustave Roussy, Université Paris-Saclay, Département D'Hématologie, Villejuif, F-94805, France
| | - O Lambotte
- Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Médecine Interne et Immunologie Clinique, Le Kremlin-Bicêtre, F-94275, France; INSERM U1184, Immunology of Viral Infections and Autoimmune Diseases, Le Kremlin-Bicêtre, F-94276, France; Université Paris Sud, UMR 1184, Le Kremlin-Bicêtre, F-94276, France; CEA, DSV/iMETI, IDMIT, Fontenay-aux-Roses, F-92265, France
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10
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di Fonzo H, Villegas Gutsch M, Castroagudin A, Cabrera MV, Mazzei ME, Rueda D. Agranulocytosis Induced by Vancomycin. Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:1053-1056. [PMID: 30174327 PMCID: PMC6135043 DOI: 10.12659/ajcr.909956] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Patient: Male, 38 Final Diagnosis: Agranulocytosis induced by Vancomycin Symptoms: Fever • pain Medication: Vancomycin Clinical Procedure: Antibiotic treatment Specialty: Hematology
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Affiliation(s)
- Horacio di Fonzo
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Melina Villegas Gutsch
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Augusto Castroagudin
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - María Victoria Cabrera
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Mariano E Mazzei
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
| | - Darío Rueda
- Department of Internal Medicine, Hospital de Clínicas "José de San Martin", University of Buenos Aires, Buenos Aires, Argentina
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11
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Popow-Stellmaszyk J, Bajorowicz B, Malankowska A, Wysocka M, Klimczuk T, Zaleska-Medynska A, Lesner A. Design, Synthesis, and Enzymatic Evaluation of Novel ZnO Quantum Dot-Based Assay for Detection of Proteinase 3 Activity. Bioconjug Chem 2018; 29:1576-1583. [DOI: 10.1021/acs.bioconjchem.8b00100] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
| | | | | | | | - Tomasz Klimczuk
- Department of Solid State Physics, Faculty of Applied Physics and Mathematics, Gdansk University of Technology, Gdansk 80-233, Poland
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Abstract
The majority of rheumatic diseases are chronic and require long-term use of disease-modifying agents to confer the best chance of controlling the disease. A significant proportion of these drugs have a risk, albeit small, of potentially serious side effects, such as neutropenia; therefore, there has been an understandable concern over the use of potentially toxic rheumatic drugs in the elderly. Factors that may contribute to this concern include age, pre-existing co-morbidities, polypharmacy, difficulty in monitoring side effects, and patient perception. The risk of using such medication needs to be balanced with their benefits in controlling chronic disease. This review discusses how rheumatic disease and anti-rheumatic medication are associated with neutropenia in an older age group. Of the rheumatic diseases, we give special focus to rheumatoid arthritis and the use of methotrexate, as well as touching on management considerations in neutropenia.
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Neerukonda AR, Lan F, Gabig T, Saraya T. Refractory Adult Primary Autoimmune Neutropenia that Responded to Alemtuzumab. Intern Med 2016; 55:1667-70. [PMID: 27301525 DOI: 10.2169/internalmedicine.55.5634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Primary autoimmune neutropenia (P-AIN) is an extremely rare disease. The most effective treatment for primary P-AIN is a granulocyte colony-stimulating factor; however, no curative treatment has been reported. We herein report a case of an adult P-AIN patient with a relatively mild medical history (irrespective of the severe neutropenia) who showed a sustained hematological response over seventeen months after the initiation of treatment with subcutaneous Alemtuzumab.
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Affiliation(s)
- Anu R Neerukonda
- Department of Medicine, SUNY Stony Brook University Hospital, USA
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Saygin C, Uzunaslan D, Ugurlu S. Antineutrophil cytoplasmic antibody-associated neutropenia in a patient with type 1 diabetes mellitus. LABORATORY HEMATOLOGY : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR LABORATORY HEMATOLOGY 2014; 20:7-8. [PMID: 25000946 DOI: 10.1532/lh96.13001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Caner Saygin
- Department of Internal Medicine, Division of Rheumatology, Istanbul University Cerahpasa Medical Faculty, Istanbul, Turkey
| | - Didem Uzunaslan
- Department of Internal Medicine, Division of Rheumatology, Istanbul University Cerahpasa Medical Faculty, Istanbul, Turkey
| | - Serdal Ugurlu
- Department of Internal Medicine, Division of Rheumatology, Istanbul University Cerahpasa Medical Faculty, Istanbul, Turkey
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Popow-Stellmaszyk J, Wysocka M, Lesner A, Korkmaz B, Rolka K. A new proteinase 3 substrate with improved selectivity over human neutrophil elastase. Anal Biochem 2013; 442:75-82. [DOI: 10.1016/j.ab.2013.07.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 07/16/2013] [Accepted: 07/19/2013] [Indexed: 10/26/2022]
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Kwon KJ, Cho KS, Kim JN, Kim MK, Lee EJ, Kim SY, Jeon SJ, Kim KC, Han JE, Kang YS, Kim S, Kim HY, Han SH, Bahn G, Choi JW, Shin CY. Proteinase 3 induces oxidative stress-mediated neuronal death in rat primary cortical neuron. Neurosci Lett 2013; 548:67-72. [DOI: 10.1016/j.neulet.2013.05.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 05/20/2013] [Accepted: 05/21/2013] [Indexed: 11/15/2022]
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Wysocka M, Lesner A, Gruba N, Korkmaz B, Gauthier F, Kitamatsu M, Łęgowska A, Rolka K. Three wavelength substrate system of neutrophil serine proteinases. Anal Chem 2012; 84:7241-8. [PMID: 22823539 DOI: 10.1021/ac301684w] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Neutrophil serine proteases, including elastase, proteinase 3, and cathepsin G, are closely related enzymes stored in similar amounts in azurophil granules and released at the same time from triggered neutrophils at inflammatory sites. We have synthesized new fluorescence resonance energy transfer (FRET) substrates with different fluorescence donor-acceptor pairs that allow all three proteases to be quantified at the same time and in the same reaction mixture. This was made possible because the fluorescence emission spectra of the fluorescence donors do not overlap and because the values of the specificity constants were in the same range. Thus, similar activities of proteases can be measured with the same sensitivity. In addition, these substrates contain an N-terminal 2-(2-(2-aminoethoxy)ethoxy)acetic acid (PEG) moiety that makes them cell permeable. Using the mixture of these selected substrates, we were able to detect the neutrophil serine protease (NSP) activity on the activated neutrophil membrane and in the neutrophil lysate in a single measurement. Also, using the substrate mixture, we were in a position to efficiently determine NSP activity in human serum of healthy individuals and patients with diagnosed Wegener disease or microscopic polyangiitis.
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Affiliation(s)
- Magdalena Wysocka
- Faculty of Chemistry, University of Gdansk, Sobieskiego 18, 80-952 Gdansk, Poland
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