1
|
Ağralı Eröz N, Elvan Tüz A, Arslan Maden A, Özcan E, Kara Aksay A, Yılmaz D. A Rare Case Presentation: EBV-related Cold Agglutinin Disease and Venous Thrombosis. Pediatr Infect Dis J 2024; 43:e218. [PMID: 38359338 DOI: 10.1097/inf.0000000000004274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Affiliation(s)
- Nesli Ağralı Eröz
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ayşegül Elvan Tüz
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aslıhan Arslan Maden
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Esin Özcan
- Department of Pediatric Hematology and Oncology, University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, İzmir, Turkey
| | - Ahu Kara Aksay
- Department of Pediatric Infectious Diseases, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Dilek Yılmaz
- Department of Pediatric Infectious Diseases, Izmir Kâtip Celebi University, Izmir, Turkey
| |
Collapse
|
2
|
Zheng Q, Wang C, Zhang Y, Xu H, Yuan F, Yi H. EBV-Associated Smooth Muscle Tumors With Autoimmune Hemolytic Anemia and Hepatitis B Infection: Report of a Previously Undescribed Neoplasm With Review. Int J Surg Pathol 2024:10668969231217631. [PMID: 38166493 DOI: 10.1177/10668969231217631] [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: 01/04/2024]
Abstract
Epstein-Barr virus-associated smooth muscle tumor (EBV-SMT) is rare in adults. The presence of intratumoral T lymphocytes and primitive rounded cells characterized this neoplasm. We report a 24-year-old Chinese man who developed EBV-SMT in the right adrenal gland with hepatitis B infection and autoimmune hemolytic anemia without a history of HIV infection, primary immune deficiency, organ transplantation, or malignant tumor. This patient had an unknown immunodeficient state. EBV-SMTs are commonly located in the liver, lung, and gastrointestinal tract but rarely in the adrenal gland. We reviewed 10 reported literature on EBV-SMT in the adrenal gland. It is imperative to distinguish EBV-SMT from conventional somatic smooth muscle tumors. The discovery of EBV-SMT forces the clinician to conduct a thorough evaluation of immune function and immune status surveillance, and these patients are vulnerable to subsequent malignant tumors.
Collapse
Affiliation(s)
- Qiaoli Zheng
- Department of Pathology, Zhu Hai People's Hospital, Zhuhai Hospital affiliated with Jinan University, Zhuhai, China
| | - Chaofu Wang
- Department of Pathology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Yuxiu Zhang
- Department of Pathology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Haimin Xu
- Department of Pathology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Fei Yuan
- Department of Pathology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| | - Hongmei Yi
- Department of Pathology, Shanghai Jiao Tong University Medical School Affiliated Ruijin Hospital, Shanghai, China
| |
Collapse
|
3
|
Al-Shakhshir S, Bannaga A, Kaddam I, Cain O, Haldar D, Armstrong MJ. Jaundice, fever and anaemia: when to avoid the cold. Frontline Gastroenterol 2022; 14:267-268. [PMID: 37056321 PMCID: PMC10086702 DOI: 10.1136/flgastro-2022-102147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/29/2022] [Indexed: 04/15/2023] Open
Affiliation(s)
- Sarah Al-Shakhshir
- Department of Hepatology and Liver Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Ayman Bannaga
- Department of Hepatology and Liver Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Israa Kaddam
- Department of Haematology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Owen Cain
- Department of Pathology, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Debashis Haldar
- Department of Hepatology and Liver Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Matthew James Armstrong
- Department of Hepatology and Liver Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| |
Collapse
|
4
|
Cabo J, Brochier A, Saussoy P, van Dievoet MA, Capirchio L, Delire B, Deneys V. Positive direct antiglobulin test in COVID-19 patients: Decision-making process. Transfus Clin Biol 2021; 28:414-419. [PMID: 34111506 PMCID: PMC8183097 DOI: 10.1016/j.tracli.2021.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 01/04/2023]
Abstract
In this unprecedented crisis of severe acute respiratory syndrome coronavirus 2 and its associated coronavirus disease 2019 (COVID-19), polymerase chain reaction and then serological testing platforms have been massively developed to face the important screening demand. Polymerase chain reaction and serological testing platforms are not the only actors impacted by the crisis, transfusion services are facing important difficulties. A positive direct antiglobulin test is frequently observed for patients encountering COVID-19. Patients with severe symptoms may develop anaemia and become good candidates for blood transfusions. The interpretation of a positive direct antiglobulin test for patients recently transfused and suffering from COVID-19 is complex. The differentiation between COVID-19 induced antibodies and possible associated transfusion alloantibodies is therefore crucial. In this context, the elution technique incorporated in an appropriate decision-making process plays its full role. This intricate topic is presented through a case report followed by literature review and finally decision-making process for COVID-19 patients necessitating red blood cells administration.
Collapse
Affiliation(s)
- J Cabo
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - A Brochier
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - P Saussoy
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - M-A van Dievoet
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - L Capirchio
- Gastroenterology department, Cliniques Universitaires St Luc, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - B Delire
- Gastroenterology department, Cliniques Universitaires St Luc, Université catholique de Louvain, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| | - V Deneys
- Clinical Biology Department, Cliniques Universitaires St Luc, Université catholique de Louvain, Banque de sang, Avenue Hippocrate 10, 1200 Woluwe-Saint-Lambert, Brussels, Belgium.
| |
Collapse
|
5
|
Poddighe D, Madiyeva A, Talipova D, Umirbekova B. Infantile giant cell hepatitis with autoimmune hemolytic anemia. World J Hepatol 2021; 13:411-420. [PMID: 33959224 PMCID: PMC8080548 DOI: 10.4254/wjh.v13.i4.411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/26/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023] Open
Abstract
Giant cell hepatitis (GCH) is characterized by large and multinucleated (syncytial) hepatocytes in the context of liver inflammation. Infantile GCH is typically associated with autoimmune hemolytic anemia in the absence of any other systemic or organ-specific autoimmune comorbidity. The etiology is unknown; concomitant viral infections (as potential trigger factors) have been identified in a few patients. The pathogenesis reportedly relies upon immune-mediated/ autoimmune mechanisms. This condition should be considered in any infant developing Coombs-positive anemia; indeed, anemia usually precedes the development of hepatitis. The clinical course is usually aggressive without the appropriate immunosuppressive therapy, which may include steroids, conventional immunosuppressors (e.g., azathioprine and cyclophosphamide as first-line treatments), intravenous immunoglobulin, and biologics (rituximab). Improvements in medical management (including the availability of rituximab) have significantly reduced the mortality of this condition in the last decade.
Collapse
Affiliation(s)
- Dimitri Poddighe
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan
- Department of Pediatrics, National Research Center for Maternal and Child Health, Nur-Sultan 010000, Kazakhstan
| | - Aidana Madiyeva
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan
| | - Diana Talipova
- Department of Medicine, Nazarbayev University School of Medicine, Nur-Sultan 010000, Kazakhstan
| | - Balzhan Umirbekova
- Department of Pediatrics, National Research Center for Maternal and Child Health, Nur-Sultan 010000, Kazakhstan
| |
Collapse
|
6
|
Graber ML, Berg D, Jerde W, Kibort P, Olson APJ, Parkash V. Learning from tragedy: the Julia Berg story. ACTA ACUST UNITED AC 2019; 5:257-266. [PMID: 30427778 DOI: 10.1515/dx-2018-0067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/22/2018] [Indexed: 12/15/2022]
Abstract
This is a case report involving diagnostic errors that resulted in the death of a 15-year-old girl, and commentaries on the case from her parents and involved providers. Julia Berg presented with fatigue, fevers, sore throat and right sided flank pain. Based on a computed tomography (CT) scan that identified an abnormal-appearing gall bladder, and markedly elevated bilirubin and "liver function tests", she was hospitalized and ultimately underwent surgery for suspected cholecystitis and/or cholangitis. Julia died of unexplained post-operative complications. Her autopsy, and additional testing, suggested that the correct diagnosis was Epstein-Barr virus infection with acalculous cholecystitis. The correct diagnosis might have been considered had more attention been paid to her presenting symptoms, and a striking degree of lymphocytosis that was repeatedly demonstrated. The case illustrates how cognitive "biases" can contribute to harm from diagnostic error. The case has profoundly impacted the involved healthcare organization, and Julia's parents have become leaders in helping advance awareness and education about diagnostic error and its prevention.
Collapse
Affiliation(s)
- Mark L Graber
- Society to Improve Diagnosis in Medicine, 5 Hitching Post, Plymouth, MA 02360, USA.,Senior Fellow, RTI International, Plymouth, MA, USA
| | | | | | - Phillip Kibort
- Children's Hospitals and Clinics of Minnesota, Minnetonka, MN, USA
| | - Andrew P J Olson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.,Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Vinita Parkash
- Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|