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Biomedical subjects

Vlatko Pejsa

Publications and source records attributed to Vlatko Pejsa.

5 recordsLinked to original sources

Multicentric glial brain tumors of a varying degree of differentiation in patient with chronic lymphocytic leukemia.

Chronic lymphocytic leukemia is associated with an increased incidence of secondary neoplasms. Primary brain tumors are rarely seen; however, an increased risk relative to the general population has been observed in male patients with chronic lymphocytic leukemia. A case report of a 62-year-old man with progressive chronic lymphocytic leukemia and pronounced neurologic symptoms is presented. Richter's syndrome or brain infiltration with leukemia cells was clinically suspected and suggested by computed tomography findings. Progression of the neurologic symptoms rapidly continued and the patient died. Neuropathologic examination revealed multicentric glial tumors of a varying degree of differentiation located throughout the brain and cerebellum.

Brain Neoplasms↗

No adverse effect of ABVD chemotherapy in a patient with chronic hepatitis C and Hodgkin's disease.

There is insufficient information on the effects of chemotherapy protocols for Hodgkin's disease (HD) and the course of coexisting hepatitis C virus (HCV) infection. A single literature case reported a patient with HD who developed fulminant hepatitis and hepatic coma after receiving chemotherapy. The case described here is of a female patient previously exposed to prolonged war stress, complicated by intravenous drug abuse and chronic hepatitis C. One year after diagnosis of HCV infection she was diagnosed with HD (nodular sclerosis type II, clinical stage IIIB). The patient received six cycles of ABVD chemotherapy (doxorubicin, bleomycin, vinblastine and dacarbazine) resulting in complete remission of HD. There was no hepatitis flare either during or after chemotherapy. In conclusion, there were no adverse effects of the ABVD regimen on the course of HCV infection in this patient who was successfully treated for HD. Because concurrent HCV infection and HD is extremely rare, we discuss here the possibility of the synergistic contribution of chronic war stress and hepatitis C infection in the pathogenesis of HD.

Adult↗

Rapid decrease in high titer of factor VIII inhibitors upon immunosuppressive treatment in severe postpartum acquired hemophilia A.

A 25-year-old woman was diagnosed with acquired hemophilia caused by factor VIII (FVIII) inhibitors two months after normal delivery of her first child. She presented with severe spontaneous bleeding in the right forearm and distal part of the right leg. After venipuncture for diagnostic purposes, severe hematoma developed, affecting the whole left arm and shoulder. The diagnosis of acquired hemophilia was confirmed by the presence of FVIII inhibitors (Bethesda units=76), low activity of factor VIII (5%), and prolonged activated partial thromboplastin time (APTT=89 s). The treatment with fresh frozen plasma, cryoprecipitate, red blood cells concentrate, methylprednisolone (3 mg/kg/day for 8 days, then 1 mg/kg/day), and cyclophosphamide (150 mg/day for 5 days, then 100 mg/day) was followed by the regression of hematomas and normalization of APTT and FVIII activity. The titer of FVIII inhibitors rapidly decreased and total disappearance of antibodies was achieved after 15 days. To the best of our knowledge, this is the shortest time to the disappearance of inhibitors to FVIII in postpartum acquired hemophilia ever reported. Transient reappearance of inhibitors occurred 10 months later and also promptly reacted to the same therapy. In the follow-up period of 4 years, the patient had two more pregnancies with no clinical and laboratory signs of illness recurrence. This case indicates important role of immunosuppressive therapy, which can rapidly induce a remission of this rare condition and be life-saving if introduced early in the course of illness and in doses higher than usually recommended.

Adult↗