Extensive bone marrow necrosis associated with antiphospholipid antibodies

Bulvik, Shlomo; Aronson, Ingrid; Ress, Stanley; Jacobs, Peter

doi:10.1016/s0002-9343(99)80016-3

Cited by 45 publications

(24 citation statements)

References 9 publications

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“…[11][12][13][14] The pathophysiology of BMN has been a subject of controversy and debate, 3 and has included toxic effects of chemotherapy, microvascular infarction, decreased oxygen tension due to increased proliferative capacity of infiltrating malignant cells, 3 tumor necrosis factor (TNF), 17 and thrombosis. [3][4] In this study, the BMN had different underlying disease processes that were initially obscured in some patients because of the necrosis, just as in previous reports. [5][6][7][8][9][10][11][12][13][14][15][16] Similar to the report of Niebrugge et al, 16 BMN preceded the diagnosis of ALL in our case 5, while in case 2, the diagnosis was not established, as the patient died early.…”

Section: Discussionsupporting

confidence: 55%

“…BMN is commonly the end result of infiltration by a neoplastic process, chemotherapy or vaso-occlusion. [2][3][4][5][6][7][8][9][10] It has also been related to the presence of antiphospholipid antibodies 4 and chemotherapy for cancer with a variety of agents. [11][12][13][14] The pathophysiology of BMN has been a subject of controversy and debate, 3 and has included toxic effects of chemotherapy, microvascular infarction, decreased oxygen tension due to increased proliferative capacity of infiltrating malignant cells, 3 tumor necrosis factor (TNF), 17 and thrombosis.…”

Section: Discussionmentioning

confidence: 99%

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Bone Marrow Necrosis: Report of Five Cases and Review of the Literature

Bashawri

Satti

2000

Ann Saudi Med

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Bone Marrow Necrosis: Report of Five Cases and Review of the Literature

Bashawri

Satti

2000

Ann Saudi Med

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“…Bone marrow necrosis occurs in a wide variety of conditions such as bacterial infections and sepsis [73] and is associated with DIC [74]. Patients with the acute respiratory distress syndrome (ARDS) and sepsis often display fat in alveolar macrophages [24,75].…”

Section: Systemic Embolisationmentioning

confidence: 99%

Fat embolism

2001

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SummaryFat embolism syndrome is a collection of respiratory, haematological, neurological and cutaneous symptoms and signs associated with trauma and other disparate surgical and medical conditions. The incidence of the clinical syndrome is low (, 1% in retrospective reviews) whilst the embolisation of marrow fat appears to be an almost inevitable consequence of long bone fractures. There is debate over the pathogenesis of fat embolism syndrome and it seems a variety of factors interact to produce a spectrum of end organ damage. Many therapeutic interventions and prophylactic strategies have been tried with varying success. Current treatments are supportive and the condition is usually associated with a good outcome. The literature on fat embolism syndrome is extensive and this review aims to discuss the incidence, aetiology, pathophysiology, diagnosis and treatment of fat embolism.

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“…Some cytokines and new antineoplastic drugs, such as interferon alpha, G-CSF, ATRA, and fludarabine, which are commonly used drugs in hematology-oncology practice, may cause BMN [26][27][28][29][30][31]. More rare causes of BMN are anorexia nervosa and hemolytic uremic syndrome (HUS), antiphospholipid syndrome (APS), and DIC, which is generally associated with disseminated metastatic disease and hyperparathyroidism [32][33][34][35][36][37][38][39].…”

Section: Introductionmentioning

confidence: 99%

Bone marrow necrosis: Clinicopathologic analysis of 20 cases and review of the literature

et al. 2002

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Bone marrow necrosis (BMN) is a relatively uncommon clinicopathologic entity. The etiology is diverse, and malignancy, especially hematopoietic in origin, is the most common underlying disease of BMN. In this retrospective analysis, cases with BMN were re-evaluated for etiology, histopathologic details, and clinical manifestations. In the last 8 years, 23 cases of BMN were detected among the 1,083 bone marrow (BM) biopsies, and the prevalence was found to be 2.2%. Three of these 23 cases with BMN were children, and 20 cases were in adults. Sixteen of these cases (80%) had underlying malignant disease, and four (20%) had nonmalignant disease. Among the malignant cases, three cases had acute myeloblastic leukemia (AML), four had relapsed Hodgkin's disease (R-HD), one had acute lymphoblastic leukemia (ALL), two had chronic myelocytic leukemia (CML), two had non-Hodgkin's lymphoma (NHL), three had disseminated intravascular coagulation (DIC) associated with metastatic solid tumor, and one had myelodysplastic syndrome/myeloproliferative syndrome (MDS/MPS). Among the nonmalignant cases, two had tuberculosis infection, one had anti-phospholipid syndrome (APS), and one had a history of drug ingestion. The most common symptoms were bone pain, fever, fatigue, and jaundice. The most common laboratory findings were variable and associated with underlying disease, but anemia, leukopenia, thrombocytopenia, and high LDH and alkaline phosphatase levels were detected in the majority of the cases, as was also seen in other series. BMN was graded according to the extent of necrosis in the BM biopsy, and necrosis was extensive in 12 cases, moderate in five cases, and mild in three cases. Increased reticulin was found in 16 cases; four cases had severe, eight had moderate, and four had mild fibrosis, and this was found to be an interesting accompanying finding in BMN. In conclusion malignancy is the most common cause of BMN but some nonmalignant conditions such as tuberculosis and APS may be the underlying cause of BMN. Am.

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Extensive bone marrow necrosis associated with antiphospholipid antibodies

Cited by 45 publications

References 9 publications

Bone Marrow Necrosis: Report of Five Cases and Review of the Literature

Bone Marrow Necrosis: Report of Five Cases and Review of the Literature

Fat embolism

Bone marrow necrosis: Clinicopathologic analysis of 20 cases and review of the literature

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