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Biomedical subjects

A A Giagounidis

Publications and source records attributed to A A Giagounidis.

9 recordsLinked to original sources
PubMed2001

Acute basophilic leukemia.

Acute basophilic leukemia has recently been included into a revised classification of acute leukemias proposed by the WHO panel. Due to the rarity of the disease, consistent diagnostic criteria are lacking. We report on two cases of acute basophilic leukemia that occurred in our department during the last 10 yr. We focus on their clinical, morphological and cytogenetic presentation. Both patients were >60 yr of age, and presented in good clinical condition with alterations to their full blood count. None had cutaneous symptoms such as erythema or urticaria. Cytogenetic analyses in the first patient showed a normal karyotype, while the second displayed a translocation t(2;6); (q23?4;p22?3), as well as a del (12)(p11). Earlier observations have linked bone marrow basophilia either to a deletion of the short arm of chromosome 12 (p11-13), to translocations involving the long arm of chomosome 6 at 6q23 or to the translocation t(6,9); (p23;q34). However, other translocations involving chromosome 6p23 have not been described before. Treatment of our patients consisted of supportive treatment in the one with normal karyotype and aggressive chemotherapy in the other patient. Both patients died within one year after diagnosis due to progressive or recurrent leukemia.

Aged↗
PubMed2000

Acute promyelocytic leukemia and pregnancy.

In acute promyelocytic leukemia (APL), the use of all-trans-retinoic acid (ATRA) as a differentiating agent induces complete remission in a high percentage of patients. In pregnancy, however, this drug bears the risk of severe teratogenicity to the child. We report the case of a 23-yr-old woman at 21 weeks' gestation suffering from APL. She was treated with ATRA (45 mg/m2) for 40 d and two courses of standard chemotherapy. The mother achieved complete remission within 22 d of treatment. Fetal development was normal, and a healthy premature girl was born in the 35th week of pregnancy. In a review of the literature we have identified 14 cases of APL in pregnancy treated with ATRA alone or in combination with chemotherapy. ATRA has been used as early as in the 3rd week of gestation and in no case have malformations or other teratogenic effects occurred. Side-effects, however, ranged from fetal cardiac arrhythmias to induction of labour. Although known to exhibit severe teratogenic effects during the first trimester of pregnancy, ATRA seems to be reasonably safe during the second and third trimesters in the treatment of APL. However, careful obstetric follow-up is mandatory regarding fetal cardiac complications.

Adult↗
PubMed1999

Pseudomonas aeruginosa orbital phlegmon in a patient treated for myelodysplastic syndrome with concomitant Sjögren's syndrome.

Pseudomonas aeruginosa orbital infections have been described very rarely in patients with neutropenia after chemotherapy. We report the case of a woman with the unusual association of Sjögren's disease and myelodysplasia, who suffered from a Pseudomonas aeruginosa orbital phlegmon after chemotherapy for her myelodysplastic syndrome. Partial intestinal antibiotic decontamination with ciprofloxacine did not prevent the infection. She was treated successfully with intravenous ceftazidime, netilmicin and granulocyte-colony stimulating factor (G-CSF). The normalization of the granulocyte count seems to play a crucial role for recovery. We present the clinical and radiological findings, discuss the therapy and review the literature concerning ocular infections due to Pseudomonas. Other infections due to this germ in immunocompromised hosts are briefly reviewed.

Aged↗
PubMed1998

Adenosine is worth trying in patients with paroxysmal supraventricular tachycardia on chronic theophylline medication.

Adenosine is widely used to terminate paroxysmal supraventricular tachycardia. However, it is usually considered of no value in patients on theophylline, for methylxanthines completely antagonize the A(1) -receptor mediated negative dromotropic adenosine effect. We report a case of a 69 year old man who had chronic obstructive lung disease and spontaneous pneumothorax. Supraventricular tachycardia with a heart rate of 200 bpm persisted even after a pleural drain was inserted and the lung became fully inflated. Although the patient was on theophylline medication with effective serum plasma levels, adenosine terminated the supraventricular tachycardia after three repeated doses of 3, 6 and 9 mg, respectively. This observation further nourishes previous hypotheses that chronic administration of an A1-receptor antagonist leads to up-regulation of the adenosine receptor number.

Adenosine↗
PubMed1997

Pseudomonas aeruginosa blepharoconjunctivitis during cytoreductive chemotherapy in a woman with acute lymphocytic leukemia.

Patients undergoing chemotherapy regimens for hematologic malignancies are prone to develop unusual and potentially life-threatening infections during periods of leukopenia- induced immunosuppression. We report the case of a woman who received consolidation chemotherapy for acute lymphocytic leukemia and acquired necrotizing Pseudomonas aeruginosa blepharoconjunctivitis of the right eye during a period of mild leukopenia. The infection led to severe orbital and periorbital inflammation, spreading down to the neck. High-dose antibiotic treatment with ceftazidime and tobramycin combined with granulocyte cell-stimulating factor cleared the infection after several days, but plastic surgery was needed to restore normal eye closure.

Adult↗
PubMed1996

Pathologic rupture of the spleen in hematologic malignancies: two additional cases.

Pathologic rupture of the spleen in hematologic malignancies is rare. We present two cases of splenic rupture which occurred in a man with a secondary high-grade non-Hodgkin's lymphoma and a woman with chronic lymphocytic leukemia (CLL). In a review of the literature, we have been able to identify 136 cases of pathologic splenic rupture since 1861; 34% have occurred in acute leukemias, 34% in non-Hodgkin's lymphomas, and 18% in chronic myelogenous leukemia (CML). We find a male-to-female ratio of 3:1, with considerable differences for the specific diseases encountered. Pathologic rupture of the spleen has happened almost exclusively in adults and the ruptured spleens are generally moderately to severely enlarged. It seems that, apart from splenic infiltration by a hematologic disease, splenic infarcts and coagulation disorders (which have previously been advanced as the most important pathophysiologic factors leading to rupture), male sex, adulthood, severe splenomegaly, and cytoreductive chemotherapy may increase the risk for pathologic splenic rupture. We briefly discuss symptoms preceding the event, diagnostic possibilities, and the outcome with operative and conservative approaches.

Fatal Outcome↗
PubMed1995

Erythrocyte indices as screening tests for the differentiation of microcytic anemias.

Algorithms for the differential diagnosis of anemias are commonly based on suspected incidences and simple laboratory parameters. Especially microcytic anemias are diagnosed using algorithms created in Mediterranean or Northern American regions. In a West German region we observe relatively high diagnostic uncertainty regarding common forms of anemias. As a hypothesis, this may be a result of inadequate algorithms not designed for regions with high incidences of anemias of chronic disease and low incidences of thalassemias. To further elucidate diagnostic problems we here report the frequencies of anemias in university hospital outpatients. Based on these data, the diagnostic values of different erythrocyte indices and of red cell distribution width in the differential diagnosis of anemias were calculated. 4525 patient files were reviewed retrospectively. 872 patients presented with anemia, 107 of which were hereditary forms and 765 of other forms. In hereditary anemias the frequency of thalassaemias (50 patients) and corpuscular hemolytic anemias (49 patients) was the same. Nearly half of the other anemias were covered by anemias of chronic disease and true iron deficiency anemias. Several indices intended to separate thalassemias from other microcytic anemias were tested for relevance. Sensitivity was between 0.75 and 0.85. Specificity was between 0.78 and 0.95. Red cell distribution width was not significantly different between thalassemias and iron deficiency. Only a red cell distribution width above 17.0 resulted in a specificity for iron deficiency of 0.91. Red cell distribution width is considered to be an unreliable screening test in a population with a low incidence of thalassemias. The high incidence of anemias of chronic disease in the region investigated should lead to more complex diagnostic procedures than offered by blood count values alone.

Anemia↗