Biomedical subjects

M van de Ree

Publications and source records attributed to M van de Ree.

3 recordsLinked to original sources

PubMed2004

Coombs-negative severe haemolytic anaemia in an immunocompetent adult following cytomegalovirus infection.

Severe haemolysis is a rare, but potentially life-threatening, complication of cytomegalovirus (CMV) infection in immunocompetent adults. Treatment with steroids or immunoglobulins, or even splenectomy, may be justified when an autoimmune mechanism can be identified as the cause of the anaemia. Described here is the case of a previously healthy patient who presented with severe haemolytic anaemia following CMV infection. The patient's haemoglobin level fell to 5.1 g/dl while extensive testing for an autoimmune mechanism remained negative. The patient made a slow but full recovery without additional medication or blood transfusions. This case demonstrates that severe haemolytic anaemia following CMV infection is possible even when presently available tests fail to show autoimmune positivity. In immunocompetent subjects a wait and see policy, with supportive care when necessary, is likely to be justified.

Adult↗

PubMed1997

[Asystole due to complex partial epilepsy].

A 56-year-old man was seen in the Emergency Room because of sudden and transient loss of consciousness. An asystole was diagnosed with 10 S duration after which a pacemaker was implanted. The patient had experienced such collapses before, preceded by odd smell sensations. After the implantation of the pacemaker, the patient did not collapse again but still experienced attacks of the same smell sensations combined with a strange feeling in his stomach. An EEG, recorded during such an attack, showed epileptic activity predominantly over the right hemisphere while at the same moment a pacemaker rhythm was observed. After the epileptic activity had stopped, normal sinus rhythm reappeared. On anticonvulsant therapy the attacks disappeared completely.

Electroencephalography↗

PubMed1990

Comparison of chloroquine, pyrimethamine and sulfadoxine, and chlorproguanil and dapsone as treatment for falciparum malaria in pregnant and non-pregnant women, Kakamega District, Kenya.

OBJECTIVE: To compare treatment and protection against falciparum malaria in pregnant and non-pregnant women with three drug regimens. DESIGN: Prospective intervention study with six weeks' follow up. Patients received one of three drug regimens in order of entry. SETTING: Primary care hospital and secondary girls' school in rural western Kenya. PATIENTS: 158 of 988 pregnant women (89 primigravid and 69 multigravid) in the third trimester and 105 of 1488 non-pregnant schoolgirls of reproductive age were parasitaemic (more than 500 asexual forms/microliter. These women were divided into three treatment groups by gravid state. INTERVENTIONS: Women were treated with chloroquine base 25 mg/kg over three days or pyrimethamine 75 mg and sulfadoxine 1500 mg as a single dose or chlorproguanil 1.2 mg/kg and dapsone 2.4 mg/kg as a single dose. MAIN OUTCOME MEASURES: Parasitaemia and haemoglobin concentrations measured at seven day intervals for six weeks. RESULTS: Primigravid women were more likely to be parasitaemic on follow up than multigravidas or nulligravidas, whose response was about the same. Parasites did not clear by day 7 in primigravidas in six (20%) of 30 who received chloroquine, three (8%) of 35 treated with pyrimethamine and sulfadoxine, and none of 23 treated with chlorproguanil and dapsone. At day 28, 83%, 19%, and 67% of primigravidas in these treatment groups were parasitaemic. Haemoglobin concentrations rose in all women, but improvement was sustained only in women who remained free of parasites. CONCLUSIONS: Clearance of parasites was better with either pyrimethamine and sulfadoxine or chlorproguanil and dapsone than with chloroquine. Longest protection was obtained with pyrimethamine and sulfadoxine.

Adolescent↗