Use of Nandrolone Decanoate in Treatment of Pure Red Cell Aplasia Secondary to Diclofenac Administration: A Case Report

Marchi, Patrícia Gelli Feres de; Vieira, André Nanny Le Sueur; Ribeiro, José Francisco; Geraldes, Silvano Salgueiro; Ramos, Paulo Roberto Rodrigues; Melchert, Alessandra; Guimarães-Okamoto, Priscylla Tatiana Chalfun

doi:10.1053/j.tcam.2017.05.007

Cited by 4 publications

(5 citation statements)

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“…After immunosuppressive treatment with cyclosporine and steroid, and hematopoietic stimulation therapy with danazol and rHuEPO, the patient had better control over his AS pain and PRCA. The use of rHuEPO in PRCA is still inconclusive, but De Marchi PN et al [3] believe that rHuEPO can be administered in cases where the immunosuppressants do not provide the desired effect. The literature reports that although the serum EPO level of patients with chronic disease anemia increases with the severity of anemia, it is still relatively insufficient.…”

Section: Discussionmentioning

confidence: 99%

“…Acquired PRCA may be primary or secondary to some autoimmune/collagen vascular disorders, inflammatory bowel disease, infections, leukemia, thymoma, drugs, or toxins. [1–3] Ankylosing spondylitis (AS) is one autoimmune disorder with an insidiously progressive and debilitating form of arthritis involving the axial skeleton. However, there is no data about whether AS can complicate with PRCA.…”

Section: Introductionmentioning

confidence: 99%

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Acquired pure red cell aplasia in a patient with ankylosing spondylitis- a case report and literature review

et al. 2019

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Rationale: Acquired pure red cell aplasia (PRCA) can be a secondary response to some autoimmune disorders. However, there is no data about the possibility of acquired PRCA being a secondary complication to ankylosing spondylitis (AS). Patient concerns: A 42-year-old male who had a history of AS for 14 years. He got serious anemia 17 months ago. Bone marrow smear indicated PRCA. Diagnose: He was diagnosed with acquired PRCA secondary to AS. Intervention: The combination treatment of immunosuppressants with hematopoiesis stimuli was successful. Outcomes: The patient recovered from PRCA, and showed improvement in his AS. Lessons: Acquired PRCA can be secondary to AS. Cyclosporine is effective in controlling AS arthritis syndrome and in addition to immunosuppressants, promotion of erythroid hematopoiesis is equally important.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acquired pure red cell aplasia in a patient with ankylosing spondylitis- a case report and literature review

et al. 2019

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“…Souza et al [ 125 ] described that after administration of nandrolone decanolate, there was no increase in femoral weight or length and there was no difference in relation to the diameter of the epiphysis and the diaphysis. Marchi et al [ 126 ] found that nandrolone stimulated bone marrow production and it could be used in the treatment of aplastic anemia. In sheep, the beneficial effect of stanozol on articular cartilage regeneration in femorotibial osteoarthritis has been confirmed [ 127 ].…”

Section: Effect Of Anabolic Steroids On Tissuesmentioning

confidence: 99%

Anabolic Steroids in Fattening Food-Producing Animals—A Review

Skoupá

Šťastný

Sládek

2022

Animals

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Anabolic steroids are chemically synthetic derivatives of the male sex hormone testosterone. They are used in medicine for their ability to support muscle growth and healing and by athletes for esthetic purposes and to increase sports performance, but another major use is in fattening animals to increase meat production. The more people there are on Earth, the greater the need for meat production and anabolic steroids accelerate the growth of animals and, most importantly, increase the amount of muscle mass. Anabolic steroids also have proven side effects that affect all organs and tissues, such as liver and kidney parenchymal damage, heart muscle degeneration, organ growth, coagulation disorders, and increased risk of muscle and tendon rupture. Anabolic steroids also have a number of harmful effects on the developing brain, such as brain atrophy and changes in gene expression with consequent changes in the neural circuits involved in cognitive functions. Behavioral changes such as aggression, irritability, anxiety and depression are related to changes in the brain. In terms of long-term toxicity, the greatest impact is on the reproductive system, i.e., testicular shrinkage and infertility. Therefore, their abuse can be considered a public health problem. In many countries around the world, such as the United States, Canada, China, Argentina, Australia, and other large meat producers, the use of steroids is permitted but in all countries of the European Union there is a strict ban on the use of anabolic steroids in fattening animals. Meat from a lot of countries must be carefully inspected and monitored for steroids before export to Europe. Gas or liquid chromatography methods in combination with mass spectrometry detectors and immunochemical methods are most often used for the analysis of these substances. These methods have been considered the most modern for decades, but can be completely ineffective if they face new synthetic steroid derivatives and want to meet meat safety requirements. The problem of last years is the application of “cocktails” of anabolic substances with very low concentrations, which are difficult to detect and are difficult to quantify using conventional detection methods. This is the reason why scientists are trying to find new methods of detection, mainly based on changes in the structure of tissues and cells and their metabolism. This review gathered this knowledge into a coherent form and its findings could help in finding such a combination of changes in tissues that would form a typical picture for evidence of anabolic misuse.

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“…In that study, the management of dogs with bone marrow suppression included supportive care such as transfusion of blood products, androgenic steroids and broad‐spectrum antibiotics 12 . There have also been a small number of case reports of dogs with bone marrow suppression that responded to treatment with bone marrow stimulants such as lithium chloride and androgens such as nandrolone 13–18 . Romiplostim, a thrombopoietin receptor agonist, has also been successfully used in the treatment of bone marrow suppression secondary to a Sertoli cell tumour 19 .…”

Section: Introductionmentioning

confidence: 99%

“…12 There have also been a small number of case reports of dogs with bone marrow suppression that responded to treatment with bone marrow stimulants such as lithium chloride and androgens such as nandrolone. [13][14][15][16][17][18] Romiplostim, a thrombopoietin receptor agonist, has also been successfully used in the treatment of bone marrow suppression secondary to a Sertoli cell tumour. 19 Despite treatment some dogs never regained full bone marrow function.…”

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confidence: 99%

Outcome of dogs with bone marrow suppression secondary to Sertoli cell tumour

Salyer

Lapsley

Palm

et al. 2021

Vet Comparative Oncology

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Sertoli cell tumours are one of the most common canine testicular neoplasia. These tumours are significantly more likely to arise in cryptorchid dogs and are often functional, oestrogen‐secreting tumours which can lead to fatal myelotoxicity. The goal of this study was to describe the outcome of dogs with oestrogen‐induced bone marrow suppression secondary to Sertoli cell tumours in seven client‐owned dogs. Medical records from April 1, 2011 through April 1, 2021 were reviewed to identify dogs that underwent surgical management of a Sertoli cell tumour with documented bone marrow suppression. Overall, 5/7 dogs required transfusion of blood products peri‐operatively. Cases 1 and 6 received a transfusion of packed red blood cells (RBC) prior to surgery and case 5 required a transfusion of whole blood. Case 1 also required a transfusion of platelets before surgery. Post‐operatively, cases 1 and 2 received packed RBC's and case 6 received two transfusions of whole blood. Case 3 required transfusions of both fresh frozen plasma and platelets post‐operatively. All dogs survived to discharge and 6/7 dogs had documented improvement in haematopoietic values. Two dogs remained chronically thrombocytopenic. The median hospital stay was 4 days. One dog died within 4 weeks of surgery from worsening pancytopenia. Survival for greater than 1 year was documented in 4/7 dogs, and one dog was lost to follow‐up 4 months post‐operatively. One dog remained severely pancytopenic 4 weeks post‐operatively and received oral lithium treatment. Improvements in all blood cell lines were observed within the 4 weeks and resolution of pancytopenia within 6 weeks. Historically, the prognosis for dogs with bone marrow suppression secondary to Sertoli cell tumours was guarded to poor. This report documented improved outcomes for dogs that underwent surgery, including one dog that received lithium chloride as treatment for Sertoli cell tumour‐induced bone marrow suppression.

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Use of Nandrolone Decanoate in Treatment of Pure Red Cell Aplasia Secondary to Diclofenac Administration: A Case Report

Cited by 4 publications

References 6 publications

Acquired pure red cell aplasia in a patient with ankylosing spondylitis- a case report and literature review

Acquired pure red cell aplasia in a patient with ankylosing spondylitis- a case report and literature review

Anabolic Steroids in Fattening Food-Producing Animals—A Review

Outcome of dogs with bone marrow suppression secondary to Sertoli cell tumour

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