RESUMEN
A myelodysplastic syndrome (MDS) was suspected in a middle-aged man who presented with neutropenia and macrocytosis. The correct non-neoplastic diagnosis was not made for 5 years. It is of crucial importance to exclude treatable causes of cytopenia and dysplasia when MDS is suspected.
Asunto(s)
Anemia Macrocítica/etiología , Síndromes Mielodisplásicos/complicaciones , Neutropenia/etiología , Cobre/deficiencia , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Síndromes Mielodisplásicos/diagnósticoRESUMEN
A 56-year-old woman presented with acute myeloid leukemia 3 years after presenting with carcinoma of the breast. Detailed investigations led to a precise diagnosis.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias de la Mama/tratamiento farmacológico , Carcinoma Ductal de Mama/tratamiento farmacológico , Leucemia Mieloide/inducido químicamente , Enfermedad Aguda , Neoplasias de la Mama/patología , Carcinoma Ductal de Mama/patología , Ciclofosfamida/efectos adversos , Doxorrubicina/efectos adversos , Femenino , Citometría de Flujo , Reordenamiento Génico , N-Metiltransferasa de Histona-Lisina , Humanos , Inmunofenotipificación , Hibridación Fluorescente in Situ , Cariotipificación , Leucemia Mieloide/tratamiento farmacológico , Leucemia Mieloide/genética , Persona de Mediana Edad , Proteína de la Leucemia Mieloide-Linfoide/genética , Inhibidores de Topoisomerasa IIRESUMEN
A case history of a man, who was found to have an asymptomatic lymphoplasmacytic lymphoma with an IgM paraproteinaemia and subsequently acquired HIV infection, is presented. After seroconversion there was a reduction in CD4+ cell count in the peripheral blood and bone marrow, together with an increase in CD 138+ cells in the marrow and disease progression with increasing paraprotein levels and falling haemoglobin. Following antiretroviral therapy (HAART) there was a reduction in viral titres, an increase in peripheral blood CD4+ cell counts together with a reduction in paraprotein and an improvement in haemoglobin. This case suggests that CD4+ cells play a role in controlling B cell proliferation and consequently that CD4 suppression contributes to the increased incidence of lymphoma in patients with HIV infection. We also discuss treatment options for this patient for should his LPL progress and require treatment in the future.
Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Infecciones por VIH/complicaciones , Leucemia Linfocítica Crónica de Células B/complicaciones , Linfoma Relacionado con SIDA/complicaciones , Terapia Antirretroviral Altamente Activa/métodos , Análisis Citogenético , Progresión de la Enfermedad , Infecciones por VIH/terapia , Humanos , Leucemia Linfocítica Crónica de Células B/inmunología , Leucemia Linfocítica Crónica de Células B/terapia , Linfoma Relacionado con SIDA/inmunología , Linfoma Relacionado con SIDA/terapia , Masculino , Persona de Mediana Edad , Paraproteínas/análisis , Inducción de Remisión , Sensibilidad y EspecificidadRESUMEN
A young man presented with systemic symptoms and marked eosinophilia. Subsequently cyclical weight gain and edema contributed to a diagnosis.