PubMed · 14114275
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I HERTZ. 1964-02-20. [PRELEUKEMIC LEUKEMIA].. https://pubmed.ncbi.nlm.nih.gov/14114275/
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Ehrlichia canis has a worldwide distribution, but clinical manifestations may vary geographically. We selected 129 dogs to determine prevalence of ehrlichiosis in dogs with anemia, thrombocytopenia, or ticks presented to a Veterinary Teaching Hospital in South Brazil. Of the 129 dogs, 68 carried the brown dog tick (Rhipicephalus sanguineus), 61 had thrombocytopenia (platelet count <150,000/microl), and 19 had anemia (PCV < 22%). Twenty dogs fulfilled more than one inclusion criteria. Ehrlichiosis was diagnosed by positive amplification of ehrlichial DNA by PCR using primers ECC and ECB that amplify a sequence of the 16S rRNA gene. Presence of E. canis was confirmed by cleavage of the amplified DNA using endonucleases HaeIII and AvaI. Fourteen of 68 (21%) dogs with ticks had ehrlichiosis, whereas 12 of 61 (20%) dogs presented with thrombocytopenia and 4 of 19 (21%) anemic dogs had ehrlichiosis. Similar results were obtained in dogs with thrombocytopenia and anemia (one of eight positive) and in dogs with thrombocytopenia and ticks (two of seven positive). All four dogs with anemia and ticks, and the dog that fulfilled all inclusion criteria yield no amplification of ehrlichial DNA by PCR. Based on our results, one in each five dogs infested by the brown dog tick, with anemia or thrombocytopenia had ehrlichosis. Contrary to widespread believe, ehrlichiosis was not the main cause for thrombocytopenia in our region.
UNLABELLED: Infantile choriocarcinoma is a highly malignant germ cell tumour sub-entity thought to originate from the placenta. The aim of this review is to alert clinicians to clinical symptoms and course of neonatal/infantile choriocarcinoma in order to improve the prognosis of affected children by early diagnosis and appropriate treatment. The clinical details of all 30 cases according to a Medline literature search including two cases documented in the MAKEI germ cell tumour study are analysed. Children suffering from infantile choriocarcinoma become symptomatic at a median age of 1 month (range 0 days-5 months). Typical early symptoms with decreasing incidence are anaemia, failure to thrive, hepatomegaly, haemoptysis or respiratory failure, there may be signs of precocious puberty. The tumour affected more than one organ in most cases; organs involved were liver (23/30 cases, 77%), lung (20/30, 67%), brain (8/30, 27%), or skin (3/30, 10%). The natural disease course is rapidly fatal. Without appropriate anti-neoplastic treatment, infantile death occurs on average within 3 weeks from first presentation with a high rate of post-mortem diagnoses (9/28, 32% of live born infants). In recent years, five reported patients (5/30, 18%) achieved a sustained remission after multi-agent cisplatinum-based chemotherapy and delayed (4/5) or primary tumour resection (1/5). beta-Human chorionic gonadotropin was universally elevated in 19/19 tested infants. Maternal choriocarcinoma was reported in 17 of the 30 cases. CONCLUSION: The differential diagnosis of infantile anaemia, failure to thrive and liver enlargement should include infantile choriocarcinoma and prompt measurement of beta-human chorionic gonadotropin.
Recombinant erythropoietin (EPO) is widely administered for long-term treatment of anemia associated with renal failure and other chronic diseases. The ability to deliver EPO by gene therapy would have clinical and economic benefit. We compared autologous and allogeneic transduced primary vascular smooth muscle cells for their ability to provide sustained EPO gene expression when encapsulated in TheraCyte devices implanted subcutaneously (SQ) or intraperitoneally (IP) in rats. Cells were transduced with retrovirus vector LrEpSN encoding rat EPO cDNA. Rats that received either autologous or allogeneic transduced cells showed elevated hematocrits (HCTs) ranging from 50 to 79% that were sustained for more than 12 months. The HCT of control rats remained at baseline (45.8%). Rats that received second SQ implants of either autologous or allogeneic cells showed elevations in hematocrit that were sustained for up to 12 months, suggesting the absence of immunological responses to transduced cells or implant material. All experimental groups had statistically significant elevated HCT (p < 0.001) when compared with controls. Both SQ and IP implantation were equally effective in delivering EPO long term. There were no significant differences in white blood cell (WBC) or platelet (PLT) values between treated and control animals. Implantation of TheraCyte devices was well tolerated and histological evaluation of the devices up to 12 months after surgery revealed a high degree of vascularization and no evidence of host immune response. TheraCyte devices offer a simple and safe gene delivery system that provides sustained therapeutic gene expression, permit removal and implantation of new devices, and do not require immunosuppression of the host.