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Biomedical subjects

J E Royal

Publications and source records attributed to J E Royal.

13 recordsLinked to original sources

Duodenal ulcer in sickle cell anemia.

A 14-year-old black male with sickle cell anemia developed a duodenal ulcer that masqueraded as sickle cell-related abdominal pain crisis on multiple occasions. Malingering and poor therapeutic compliance aggravated the ulcer in this patient, who ultimately succumbed to a catastrophic bleed. Duodenal ulcer appears to be an infrequent but difficult to treat lesion in sickle cell disease. An in-depth review on the occurrence of duodenal ulcer in sickle cell anemia is presented. The etiological mechanisms of peptic ulcer disease in this population and the potential benefits of transfusion therapy are discussed.

Abdominal Pain↗

Facial bone infarcts in sickle cell syndromes.

Bone infarction in the sickle cell syndromes (sickle cell anemia, sickle beta thalassemia, and sickle C disease) is common in the long bones, but the facial bones, particularly the orbits, are infrequently involved. In a review of the literature, only 13 cases of facial bone infarcts in sickle cell syndromes were found. Seven episodes of facial bone infarcts--four orbital, two mandibular, and one in the zygomatic arch--in six patients encountered at the authors' institution are reported. Five patients had hemoglobin SS, and one had hemoglobin SC. Bone marrow scans were positive for infarction in five of the six episodes during which they were obtained, which highlights the usefulness of this technique in the diagnosis of facial bone infarction.

Adolescent↗

Ganglioneuroblastoma and fetal hydantoin-alcohol syndromes.

A ganglioneuroblastoma developed in a 35-month-old boy with both the fetal hydantoin and fetal alcohol syndromes. Our case, plus two recent reports in the literature, would very likely establish the relationship between fetal hydantoin syndrome and the development of neural crest tumors. Infants exposed in utero to hydantoins should be closely observed for the development of these tumors.

Abnormalities, Drug-Induced↗

Hemorrhagic cystitis with MOPP therapy.

After 12 cycles of MOPP therapy for Hodgkin's Disease, an adolescent black male developed hemorrhagic cystitis, which clinically and histologically was similar to that induced by cyclophosphamide. At that time he had a normal platelet count and had never been irradiated below the diaphram. The markedly contracted bladder returned to normal approximately one month following cessation of therapy.

Child↗