Acquired Hemophilia A (AHA) is a bleeding diathesis related to the development of factor VIII inhibitor, which can frequently go undetected. It commonly manifests as spontaneous mucosal bleeds without any known history of a bleeding disorder, but has the potential to cause life threatening bleeding especially in elderly patients with underlying comorbidities. Here we describe a case of AHA in a 78 year old female presenting with spontaneous mucocutaneous bleeding as tongue hematoma and recurrent gastrointestinal (GI) bleeding. Underlying etiology remained unclear in this case. While she did not require any reversal agents to control bleeding, the patient received steroids and rituximab as inhibitor eradication therapy.
P ¼ 0.26) or de novo and secondary MDS separately (OR 1.70, P ¼ 0.25 and OR 1.53, P ¼ 0.53, respectively).Finally, there was no correlation detected between RAD51 and XRCC3 SNPs and the presence of an abnormal karyotype or karyotypic complexity. A much larger study would be required to determine if these SNPs are associated with any specific karyotypic abnormality.Although there may still be minor differences in allele frequency of RAD51 135G > C and XRCC3 T241M, our results overall suggest that these polymorphisms do not play a major role in the pathogenesis of MDS.
Metastasis of extra-intestinal carcinoma to the gastrointestinal tract (GIT) is a rare event, most commonly occurring with malignant melanoma. Anti-PD-1 (programmed death-1) immunotherapeutic agents are immune checkpoint inhibitors with proven benefit across multiple cancer types, including squamous cell carcinoma of the head and neck (SCCHN). Here we describe a case of small bowel perforation attributed to a primary SCCHN metastasizing to the GIT in the setting of treatment with PD-1 inhibitors.
Patient: Male, 53-year-old
Final Diagnosis: Hodgkin lymphoma • superior vena cava syndrome
Symptoms: Dry cough • dyspnea • facial edema • fatigue
Medication: —
Clinical Procedure: —
Specialty: Hematology • Oncology
Objective:
Rare co-existance of disease or pathology
Background:
Hodgkin lymphoma (HL) is a relatively rare etiology of superior vena cava (SVC) syndrome, with only 24 cases reported in the literature. The characteristics, management, and prognosis of HL-associated SVC syndrome remain unclear. This case report describes nodular sclerosis classical HL and the associated clinical manifestations presenting as SVC syndrome in a middle-aged patient, and it summarizes the characteristics of HL-associated SVC syndrome.
Case Report:
In this case report, we present a 53-year-old Hispanic man with progressively worsening dyspnea, dry cough, facial and neck edema, and dysphagia. SVC syndrome was diagnosed, and pathology revealed nodular sclerosis classical HL. The patient was treated with doxorubicin, bleomycin, vinblastine, and dacarbazine. SVC syndrome improved, and repeated imaging showed that the lymphoma had decreased in size and had become metabolically inactive.
Conclusions:
We reviewed the characteristics, management, and prognosis of HL-associated SVC syndrome, which may indicate more advanced and recurrent progression in patients with HL. This possibility suggests that physicians should provide urgent diagnosis and closer follow-up, and more aggressive therapies may be needed because of the high risk of recurrence. Therapy may induce late-onset SVC syndrome in patients with HL.
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