Immune Thrombocytopenia and Hemolytic Anemia as a Presenting Manifestation of Hodgkin Disease

Ertem, Mehmet; Uysal, Zümrüt; Yavuz, Gülsan; Gözdaşoĝlu, Sevgi

doi:10.1080/088800100276550

Cited by 28 publications

(23 citation statements)

References 9 publications

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“…The recent Consensus Recommendations of IAPCOI [1] has recommended the 0-6wks-6months schedule, the first dose to be administered at birth, second dose at 6 weeks and third dose at 6 months. The reason being it is more closer to immunologically ideal and most widely used 0-1-6 months schedule, and also conforms to latest ACIP recommendations wherein the final dose in the Hepatitis-B vaccine series should be administered no earlier than 24 weeks and at least 16 weeks after the first dose [2] . Therefore, the question arises as to the rationality of…”

Section: Hepatitis B Vaccinationmentioning

confidence: 69%

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Immune thrombocytopenic purpura with acute lymphoblastic leukemia-an unusual association

Dua¹,

Sharma²

2012

Indian Pediatr

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aspiration and biopsy was performed. An adequate number of megakaryocytes with findings of ALL in remission were detected, there was nothing suggestive of myelodysplastic syndrome. The patient was started on prednisone at 2 mg/kg orally daily. After 3 weeks of prednisolone, she had improvement of her platelet count to 78000/mm 3 . Her last platelet count in July 2012 was 88000/mm 3 . Secondary causes of ITP were ruled out: antinuclear antibodies was negative, double stranded DNA was 14 IU/mL, IgG, IgA, IgM and IgE were 540,35,118 and 18mg/dL, Hepatitis B, Hepatitis C and HIV studies were negative, and anti-phospholipid antibodies (APLA) and direct coomb's test were also negative.To conclude, the presence of thrombocytopenia in patient of ALL does not always means relapse of ALL or as a result of chemotherapy but the possibility of ITP should also be considered.

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Section: Hepatitis B Vaccinationmentioning

confidence: 69%

“…Hematologic malignancies such as Hodgkins lymphoma, Non-Hodgkin lymphoma and chronic lymphocytic leukemia have been associated with immune thrombocytopenic purpura (ITP) but it is rare to see ITP in patient with acute lymphoblastic leukemia (ALL) [1,2]. ALL is a immunosuppressive disease and chemotherapy results in further immunosuppressive state.…”

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confidence: 99%

Immune thrombocytopenic purpura with acute lymphoblastic leukemia-an unusual association

Dua¹,

Sharma²

2012

Indian Pediatr

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“…Untreated ALL is usually fatal within 6 months, but with the best therapy 70-80% of children and 20-30% of adults survive beyond 5 years [13]. Acute leukemia in remission followed by ITP was not found in the course of our literature even though, found documented are many ITP associated disorders [14,15] involving lymphocyte abnormalities like large granular lymphocyte syndrome, lymphoproliferative disorders like Chronic Lymphocytic Leukemia (CLL) and lymphomas, others include autoimmune lymphoproliferative disorders, autoimmune haemolytic anaemias, Systemic Lupus Erythematosus (SLE) and antiphospholipid syndrome; direct link of ALL with ITP is yet to be reported in literature. The closest reported was AML masquerading as ITP [6].…”

Section: Discussionmentioning

confidence: 68%

Immune Thrombocytopenic Purpura Following Acute Lymphoblastic Leukemia in Remission

A¹,

S²,

D³

2015

J Leuk

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He was diagnosed with adult polycystic kidney disease in India 2 years previously following severe systemic hypertension and has been on anti-hypertensive -Tabs Valsartan 160 mg daily and Tabs Carvedilol 25 mg bd. His mother had adult polycystic kidney disease post renal transplantation in India. He is the 2 nd of three children in a monogamous family setting.The physical examination at presentation revealed a young man who was well built, fully conscious and alert, not pale, afebrile, anicteric with extensive bilateral sub-conjunctival haemorrhages, petechiae haemorrhages on the lips, gum bleeds, a left lower cervical lymphadenopathy and no pedal edema.The chest examination revealed no abnormalities. The Cardiovascular system revealed a pulse of 100 beats per minute, blood pressure was 160/120 mmHg with heart sounds I and II only. The abdomen was full and moves with respiration, moderate generalized tenderness and guarding, both kidneys were bimanually palpable but there was no palpably enlarged liver and spleen.He was admitted and managed by the Haematology and Nephrology teams. Complete blood counts at presentation showed haematocrit of 0.38, white cell of 6.5×10 9 /L, platelet count of 6.0 × 10 9 /L, Neutrophils-61%, lymphocytes-29%, monocytes-8%, Eosinophils-1% and Basophils-1%. The peripheral blood film review showed red blood cells with moderate hypochromia and severe microcytosis ( Figure 1). The white cells showed primitive intermediate sized lymphoblasts with high nucleo-cytoplasmic ratio and pale blue agranular cytoplasm. Some of these cells have 1-2 prominent nucleoli. These lymphoblasts constitute about 40% of all circulating white cells. There was also

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“…Immune thrombocytopenia (ITP) is frequently associated with HD as well [7, 8]. However, combined AIHA and ITP (Evans syndrome) has rarely been reported in association with HD [4, 9, 10, 11]. We report here a case of HD associated with DAT-negative Evans syndrome and discuss the significance of the measurement of RBC-IgG in cases of HD with anaemia.…”

Section: Introductionmentioning

confidence: 98%

Direct-Antiglobulin-Test-Negative Immune Haemolytic Anaemia and Thrombocytopenia in a Patient with Hodgkin’s Disease

et al. 2001

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A case of direct-antiglobulin-test (DAT)-negative auto-immune haemolytic anaemia (AIHA) and immune thrombocytopenia (ITP) associated with Hodgkin’s disease (HD) is reported. A 52-year-old male was admitted with anaemia, thrombocytopenia, and lymphadenopathy. The patient was DAT negative, although he exhibited the clinical features of warm-type AIHA and elevated levels of red-blood-cell-associated IgG (RBC-IgG). The serum level of platelet-associated IgG (PA-IgG) was markedly increased. A biopsy specimen of the inguinal lymph nodes showed HD of mixed cellularity. Marked improvement of subjective symptoms, normalization of haematological values and a decrease in the level of both RBC- and PA-IgG were observed after the start of combination chemotherapy for HD. Although the association of HD, ITP, and/or AIHA has been infrequently reported, the measurement of RBC-IgG is recommended in cases of HD with anaemia even though DAT is negative, since HD is known to be associated with various protean immunological abnormalities.

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Immune Thrombocytopenia and Hemolytic Anemia as a Presenting Manifestation of Hodgkin Disease

Cited by 28 publications

References 9 publications

Immune thrombocytopenic purpura with acute lymphoblastic leukemia-an unusual association

Immune thrombocytopenic purpura with acute lymphoblastic leukemia-an unusual association

Immune Thrombocytopenic Purpura Following Acute Lymphoblastic Leukemia in Remission

Direct-Antiglobulin-Test-Negative Immune Haemolytic Anaemia and Thrombocytopenia in a Patient with Hodgkin’s Disease

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