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1.
Artigo em Japonês | MEDLINE | ID: mdl-36560905

RESUMO

Methicillin-resistant Staphylococcus aureus (MRSA) strains showing POT type 106-77-113 have been associated with USA300. Additionally, many strains produce Panton-Valentine Leukocidin (PVL). Until 2018, 106-77-113 was the most dominant POT-type PVL-producing bacteria isolated in our hospital; however, in 2018, one strain with POT type 106-255-121 was isolated, and thereafter, since 2019, an increasing trend towards isolation of this strain has been observed. In this study, we compared two PVL-producing strains detected in skin infections-derived materials from outpatients during the three-year period between 2019 and 2021 through genetic analysis using next-generation sequencers. Eight, each of POT types 106-77-113 (POT-A) and 106-255-121 (POT-B), strains were included in this study, and PVL productivity, drug susceptibility, multi-locus sequencing typing (MLST), and resistance genes and virulence genes were detected. Both the groups shared the same MLST profile (3-3-1-1-4-4-3), but a single nucleotide mutation of ARCC was detected in POT-B type strain, which was determined to be similar to ST 8 of POT-A and POT-B type strains. Only POT-B type strains harbored aac(6')-aph(2″) and erm(A) genes, consistent with the results of drug susceptibility tests. All the strains were resistant to GM and CAM and were positive to D-zone test. On the other hand, the POT-A strains were sensitive to GM, and 7 of 8 strains were sensitive to CLDM and MINO. However, one POT-A type strain was found to harbor erm(C), tet(K), and tet(M) genes and was resistant to CAM, CLDM, and MINO. Both groups of isolates harbored 17 genes including ACME, lukF-PV, and LukS-PV, and no difference in pathogenicity was observed. In our hospital, one strain of POT type 106-255-121 was isolated for the first time in 2018, and the number of isolates of this type has been increasing since then. The present study confirms that POT type 106-255-121 strains have the same virulence as POT type 106-77-113 strains have and have also acquired a drug resistance gene.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Dermatopatias Infecciosas , Infecções Estafilocócicas , Humanos , Antibacterianos , Staphylococcus aureus Resistente à Meticilina/genética , Tipagem de Sequências Multilocus , Infecções Estafilocócicas/genética , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética
2.
Pediatr Blood Cancer ; 67(7): e28341, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32323914

RESUMO

BACKGROUND: Rearrangements of chromosome 8q24/MYC (8q24/MYC-r), resulting from t(8;14)(q24;q32), t(2;8)(p11;q24), or t(8;22)(q24;q11), are mainly associated with Burkitt lymphoma/leukemia (BL) and rarely observed in patients with B-cell precursor acute lymphoblastic leukemia (BCP-ALL). The characteristics of BCP-ALL with 8q24/MYC-r are poorly understood. PROCEDURE: A retrospective nationwide study of data from patients with pediatric BCP-ALL with 8q24/MYC-r in Japan was conducted to clarify the clinical and biological characteristics associated with 8q24/MYC-r BCP-ALL. RESULTS: Ten patients with BCP-ALL with 8q24/MYC-r, including three with double-hit leukemia (DHL) (two with t(8;14)(q24;q32) and t(14;18)(q32;q21) and one with t(8;14) and t(3;22)(q27;q11)), were identified. Patients with BCP-ALL with 8q24/MYC-r had higher median age and uric acid and lactate dehydrogenase levels, than those without 8q24/MYC-r. All patients were initially treated with ALL-type chemotherapy; however, four, including one with DHL, were switched to BL-type chemotherapy, based on cytogenetic findings. One patient relapsed after standard-risk ALL-type chemotherapy, and two patients with DHL did not attain complete remission with chemotherapy; all three died within 11 months. The other seven patients treated with BL-type or high-risk ALL-type chemotherapy are alive without disease. CONCLUSIONS: The clinical and laboratory features of BL with IG-MYC rearrangement, displaying a BCP immunophenotype (Wagener et al. and Herbrueggen et al. termed it as pre-BLL), are similar to those of BCP-ALL with 8q24/MYC-r. Low-risk ALL-type chemotherapy may not be appropriate for them, and further studies are required to establish an adequate therapeutic strategy. Further studies of DHL to identify new treatment strategies are also needed.


Assuntos
Biomarcadores Tumorais/genética , Cromossomos Humanos Par 8/genética , Rearranjo Gênico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Proteínas Proto-Oncogênicas c-myc/genética , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras B/epidemiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/patologia , Prognóstico , Estudos Retrospectivos
3.
Genes Chromosomes Cancer ; 58(8): 521-529, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30739374

RESUMO

Cell-free DNA (cfDNA), which are small DNA fragments in blood derived from dead cells including tumor cells, could serve as useful biomarkers and provide valuable genetic information about the tumors. cfDNA is now used for the genetic analysis of several types of cancers, as a surrogate for tumor biopsy, designated as "liquid biopsy." Rhabdomyosarcoma (RMS), the most frequent soft tissue tumor in childhood, can arise in any part of the body, and radiological imaging is the only available method for estimating the tumor burden, because no useful specific biological markers are present in the blood. Because tumor volume is one of the determinants of treatment response and outcome, early detection at diagnosis as well as relapse is essential for improving the treatment outcome. A 15-year-old male patient was diagnosed with alveolar RMS of prostate origin with bone marrow invasion. The PAX3-FOXO1 fusion was identified in the tumor cells in the bone marrow. After the diagnosis, cfDNA was serially collected to detect the PAX3-FOXO1 fusion sequence as a tumor marker. cfDNA could be an appropriate source for detecting the fusion gene; assays using cfDNA have proved to be useful for the early detection of tumor progression/recurrence. Additionally, the fusion gene dosage estimated by quantitative polymerase chain reaction reflected the tumor volume during the course of the treatment. We suggest that for fusion gene-positive RMSs, and other soft tissue tumors, the fusion sequence should be used for monitoring the tumor burden in the body to determine the diagnosis and treatment options for the patients.


Assuntos
Biomarcadores Tumorais , DNA Tumoral Circulante , Proteínas de Fusão Oncogênica/genética , Fatores de Transcrição Box Pareados/genética , Rabdomiossarcoma Alveolar/diagnóstico , Rabdomiossarcoma Alveolar/genética , Adolescente , Biópsia , Detecção Precoce de Câncer , Humanos , Masculino , Reação em Cadeia da Polimerase , Tomografia por Emissão de Pósitrons , Prognóstico , Recidiva , Rabdomiossarcoma Alveolar/terapia , Análise de Sequência de DNA
4.
Artigo em Inglês | MEDLINE | ID: mdl-32312077

RESUMO

OBJECTIVE: Mycoplasma hominis usually colonizes the lower urogenital tract and has been occasionally associated with pelvic inflammatory disease, postpartum fever, preterm labor in pregnant females. The aim of this study was to investigate the incidence and antimicrobial susceptibilities of M. hominis isolated from the urogenital tracts of pregnant females. METHODS: Specimens were obtained from the urogenital tract of pregnant females at Department of Obstetrics and Gynecology, Ehime University Hospital, between November 2014 and December 2017. The identification of M. hominis was confirmed by the polymerase chain reaction (PCR) methods. The minimum inhibitory concentrations (MICs) of antibiotics were measured using a broth microdilution assay. RESULTS: Of the 1074 specimens tested, 63 (5.9%) were positive for M. hominis. The M. hominis-positive rate was highest at 21.3% between 18 and 24 years old. The 21 (25.6%) of 82 patients with bacterial vaginosis were positive for M. hominis. The 17 (40.5%) of 42 patients delivered by cesarean section that occurred infections including of intrauterine infection and pelvic abscess were positive for M. hominis. They were all administered ß-lactam antibiotics before and after cesarean section. All patients recovered immediately following administration of clindamycin (CLDM). ß-lactam antibiotics, macrolides and fosfomycin (FOM) were all resistant against M. hominis strains. In contrast, M. hominis strains were susceptible to CLDM, minocycline (MINO) and quinolones. CONCLUSIONS: Our data suggests that the prevalence of genital M. hominis in pregnant females is high at younger age, bacterial vaginosis and infections after cesarean section with ß-lactam antibiotics administration. CLDM, MINO and quinolones may be recommended against M. hominis infection. Especially, CLDM can be used as the adequate agent for pregnant females because tetracycline and quinolones are undesirable during pregnancy and lactation.


Assuntos
Farmacorresistência Bacteriana , Infecções por Mycoplasma , Mycoplasma hominis , Complicações Infecciosas na Gravidez , Adolescente , Adulto , Antibacterianos , Cesárea , Feminino , Humanos , Incidência , Recém-Nascido , Testes de Sensibilidade Microbiana , Mycoplasma hominis/efeitos dos fármacos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Adulto Jovem
5.
Neuropathology ; 38(2): 179-184, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28971535

RESUMO

Medulloepithelioma is a rare and highly malignant primitive neuroectodermal tumor that usually occurs in childhood. The diagnosis of this entity required only morphological analysis until the World Health Organization classification of central nervous system (CNS) tumors was revised, and now genetic analysis is necessary. We report a case of medulloepithelioma in the posterior cranial fossa that was diagnosed by both morphological and genetic analyses based on this classification. A 10-month-old girl was admitted to our hospital with consciousness disturbance and vomiting. Neuroimaging revealed a partially calcified mass and cyst formation in the posterior cranial fossa. Partial resection of the tumor was performed and histological findings revealed multilayered rosettes with LIN28A staining, but genetic analysis showed no amplification of the C19MC microRNA cluster at 19q14.32. Therefore, we diagnosed the tumor as medulloepithelioma belonging to other CNS embryonal tumors. The patient was immediately treated with systemic high-dose chemotherapy. Follow-up neuroimaging 10 months later showed no signs of recurrence. Medulloepitheliomas are difficult to diagnose by routine HE staining and require combined morphological, immunohistochemical and genetic analyses to provide an accurate diagnosis.


Assuntos
Neoplasias Encefálicas/diagnóstico , Fossa Craniana Posterior , Tumores Neuroectodérmicos Primitivos/diagnóstico , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/genética , Neoplasias Encefálicas/patologia , Fossa Craniana Posterior/diagnóstico por imagem , Fossa Craniana Posterior/patologia , Feminino , Humanos , Hidrocefalia/diagnóstico por imagem , Imuno-Histoquímica , Lactente , Antígeno Ki-67/metabolismo , MicroRNAs/metabolismo , Tumores Neuroectodérmicos Primitivos/diagnóstico por imagem , Tumores Neuroectodérmicos Primitivos/genética , Tumores Neuroectodérmicos Primitivos/patologia , Proteínas de Ligação a RNA/metabolismo
6.
Pediatr Hematol Oncol ; 35(5-6): 341-349, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30633606

RESUMO

Chronic granulomatous disease (CGD) is a hereditary immunodeficiency syndrome caused by a defect in the NADPH oxidase complex, which is essential for bactericidal function of phagocytes. Approximately 70% of patients with CGD have a mutation in the CYBB gene on the X chromosome, resulting in defective expression of gp91phox, one of the membrane-bound subunits of NADPH oxidase. Although most patients with X-linked CGD are males, owing to transmission of this disease as an X-linked recessive trait, there are female patients with X-linked CGD. Here, we report the case of a teenage girl with X-linked CGD associated with a heterozygous mutation in exon 5 of the CYBB gene (c.389G > C; R130P), which causes skipping of exon 5, resulting in a premature stop codon in exon 6 of CYBB. Accurate pro-mRNA splicing for mature mRNA formation is regulated by several splicing mechanisms that are essential for appropriate recognition of exonic sequences. The c.389G > C mutation disrupts exonic-splicing regulator sequences, thereby resulting in the aberrant skipping of exon 5 in the CYBB transcript of the patient. The patient showed an extremely skewed (≥96%) X inactivation pattern of the HUMARA locus; this inactivation is thought to be responsible for the development of CGD not only in neutrophils but also in monocytic, T-cell, and B-cell lineages and in CD34-positive immature hematopoietic cells. Our case and other reports indicate that the onset of X-linked CGD in female patients tends to occur later in life, and that the symptoms tend to be milder as compared to male patients.


Assuntos
Cromossomos Humanos X/genética , Éxons , Doença Granulomatosa Crônica , NADPH Oxidase 2 , Mutação Puntual , RNA Mensageiro , Inativação do Cromossomo X , Criança , Feminino , Loci Gênicos , Doença Granulomatosa Crônica/enzimologia , Doença Granulomatosa Crônica/genética , Doença Granulomatosa Crônica/patologia , Humanos , NADPH Oxidase 2/genética , NADPH Oxidase 2/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores Androgênicos/genética , Receptores Androgênicos/metabolismo
7.
Pediatr Hematol Oncol ; 35(2): 125-130, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29648910

RESUMO

Primary bone marrow lymphoma (PBML) is hard to diagnose in children, due to the difficult identification of malignant cells in bone marrow. The first case, a 5-year-old boy, showed knee swelling with an intermittent fever. The second case, a 12-year-old girl, showed fever of unknown origin without lymphadenopathy or hepatosplenomegaly. In both cases, the diagnosis was not confirmed despite the repeated bone marrow aspirations. Finally, bone marrow aspiration and biopsy at the positive site by positron emission tomography (PET)-CT contributed to definitive diagnosis of PBML. The PET-CT is useful for the accurate diagnosis of PBML in children with non-specific symptoms.


Assuntos
Neoplasias da Medula Óssea/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Tomografia por Emissão de Pósitrons , Tomografia Computadorizada por Raios X , Criança , Pré-Escolar , Feminino , Humanos , Masculino
8.
Pediatr Hematol Oncol ; 35(5-6): 355-361, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30457427

RESUMO

Although outcomes for infant leukemia have improved recently, transient adrenal insufficiency is commonly observed during treatment, especially after glucocorticoid administration. We identified three infants with acute leukemia who suffered from prolonged adrenal insufficiency requiring long-term (from 15 to 66 months) hydrocortisone replacement. All infants showed life-threatening symptoms associated with adrenal crisis after viral infections or other stress. Severe and prolonged damage of hypothalamo-pituitary-adrenal (HPA) axis is likely to occur in early infants with leukemia, therefore routine tolerance testing to evaluate HPA axis and hydrocortisone replacement therapy are recommended for infants with leukemia to avoid life-threatening complications caused by adrenal crisis.


Assuntos
Insuficiência Adrenal , Glucocorticoides/efeitos adversos , Leucemia/tratamento farmacológico , Doença Aguda , Insuficiência Adrenal/induzido quimicamente , Insuficiência Adrenal/metabolismo , Insuficiência Adrenal/patologia , Insuficiência Adrenal/terapia , Pré-Escolar , Feminino , Glucocorticoides/administração & dosagem , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipotálamo-Hipofisário/patologia , Recém-Nascido , Leucemia/metabolismo , Leucemia/patologia , Masculino , Sistema Hipófise-Suprarrenal/metabolismo , Sistema Hipófise-Suprarrenal/patologia , Fatores de Tempo
9.
Br J Haematol ; 171(5): 818-29, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26403224

RESUMO

Acute lymphoblastic leukaemia (ALL) in infants is an intractable cancer in childhood. Although recent intensive chemotherapy progress has considerably improved ALL treatment outcome, disease cure is often accompanied by undesirable long-term side effects, and efficient, less toxic molecular targeting therapies have been anticipated. In infant ALL cells with KMT2A (MLL) fusion, the microRNA let-7b (MIRLET7B) is significantly downregulated by DNA hypermethylation of its promoter region. We show here that the expression of HMGA2, one of the oncogenes repressed by MIRLET7B, is reversely upregulated in infant ALL leukaemic cells, particularly in KMT2A-AFF1 (MLL-AF4) positive ALL. In addition to the suppression of MIRLET7B, KMT2A fusion proteins positively regulate the expression of HMGA2. HMGA2 is one of the negative regulators of CDKN2A gene, which encodes the cyclin-dependent kinase inhibitor p16(INK4A) . The HMGA2 inhibitor netropsin, when combined with demethylating agent 5-azacytidine, upregulated and sustained the expression of CDKN2A, which resulted in growth suppression of KMT2A-AFF1-expressing cell lines. This effect was more apparent compared to treatment with 5-azacytidine alone. These results indicate that the MIRLET7B-HMGA2-CDKN2A axis plays an important role in cell proliferation of leukaemic cells and could be a possible molecular target for the therapy of infant ALL with KMT2A-AFF1.


Assuntos
Proteína HMGA2/antagonistas & inibidores , MicroRNAs/farmacologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Azacitidina/farmacologia , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/fisiologia , Metilação de DNA/efeitos dos fármacos , Proteínas de Ligação a DNA/metabolismo , Sinergismo Farmacológico , Técnicas de Silenciamento de Genes , Genes p16 , Histona-Lisina N-Metiltransferase/metabolismo , Histona-Lisina N-Metiltransferase/fisiologia , Humanos , Lactente , MicroRNAs/fisiologia , Terapia de Alvo Molecular/métodos , Proteína de Leucina Linfoide-Mieloide/metabolismo , Proteína de Leucina Linfoide-Mieloide/fisiologia , Netropsina/farmacologia , Proteínas Nucleares/metabolismo , Regiões Promotoras Genéticas/efeitos dos fármacos , Fatores de Elongação da Transcrição , Regulação para Cima
10.
Eur J Haematol ; 94(2): 177-81, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24766281

RESUMO

Juvenile myelomonocytic leukemia (JMML) is a clonal disease arising from abnormal hematopoietic stem cells, although the involvement of lymphoid lineage differs among reported cases. Here, we present a case of JMML with a KRAS G13D mutation. The mutation was detected in various hematopoietic lineages, including T and B lymphocytes and also in lineage(-) CD34(+) CD38(-) hematopoietic stem cells, showing a different percentage of affected cells in each lineage. Single cell-based analysis of hematopoietic cells revealed the loss of wild-type KRAS in a significant proportion of G13D-harboring cells. The percentage of loss of heterozygosity (LOH)/non-LOH cells showed lineage-dependent skewing in hematopoietic cells. The loss of the wild-type KRAS allele may be a common secondary genetic change in KRAS-related JMML and may affect the differentiation behavior of early JMML progenitors.


Assuntos
Linhagem da Célula/genética , Leucemia Mielomonocítica Juvenil/diagnóstico , Leucemia Mielomonocítica Juvenil/genética , Perda de Heterozigosidade , Proteínas Proto-Oncogênicas/genética , Proteínas ras/genética , Alelos , Medula Óssea/patologia , Células da Medula Óssea/metabolismo , Células da Medula Óssea/patologia , Humanos , Imunofenotipagem , Lactente , Leucemia Mielomonocítica Juvenil/metabolismo , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/patologia , Masculino , Mutação , Polimorfismo de Nucleotídeo Único , Proteínas Proto-Oncogênicas p21(ras)
11.
Pediatr Int ; 57(1): e7-10, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25711272

RESUMO

Tsukamurella spp. infection is a rare but important cause of bacteremia in immunocompromised patients. The organism is an aerobic, Gram-positive, weakly acid-fast bacillus that is difficult to differentiate from other aerobic Actinomycetales by standard laboratory methods. Here, we report on the case of a 14-year-old patient with Hodgkin's lymphoma who, after intensive chemotherapy, developed Tsukamurella inchonensis bacteremia, which was identified on the peripherally inserted central venous catheter (PICC) using 16S rRNA sequencing analysis. The bacteremia was successfully controlled with antimicrobial therapy and subsequent removal of the PICC. This is the first report of bacteremia by Tsukamurella inchonensis in immunocompromised children. Careful observation and prompt analysis of opportunistic infection, including Tsukamurella spp., is very important in immunocompromised children.


Assuntos
Bacteriemia/microbiologia , Bactérias Aeróbias/isolamento & purificação , Infecções Relacionadas a Cateter/microbiologia , Cateterismo Venoso Central/efeitos adversos , Infecções por Bactérias Gram-Positivas/microbiologia , Doença de Hodgkin/complicações , Hospedeiro Imunocomprometido , Adolescente , Bacteriemia/etiologia , Infecções Relacionadas a Cateter/etiologia , Infecções por Bactérias Gram-Positivas/etiologia , Humanos , Masculino
12.
Pediatr Int ; 57(2): 263-8, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25223367

RESUMO

BACKGROUND: Serum procalcitonin (PCT) increases in various respiratory disorders such as acute respiratory distress syndrome. Elevated PCT is also observed in healthy neonates. In this study, we investigated whether PCT is a good marker of respiratory disorder in neonates. METHODS: A total of 155 neonates with or without respiratory disorder, were eligible for the study. PCT was measured on electrochemiluminescence immunoassay. Each neonate was allocated to the non-respiratory disorder (control) group (n = 95), or a respiratory disorder group (n = 60). PCT was compared between the groups, and association with other markers, including C-reactive protein (CRP) and white blood cell (WBC) count, was analyzed. RESULTS: Of the 60 neonates in the respiratory disorder group, 39, 10, five, one, two, two, and one neonates had transient tachypnea of the newborn, respiratory distress syndrome, air leak syndrome, meconium aspiration syndrome, 18-trisomy, neonatal asphyxia, and congenital diaphragmatic hernia, respectively. Mean PCT, CRP and WBC count in the respiratory disorder group were 9.01 ng/mL, 0.26 mg/dL, and 16,100 cells/µL, respectively. The area under the curve obtained for PCT in distinguishing between the respiratory disorder and control groups was 0.85 (sensitivity, 66.7%; specificity, 93.0%; optimum cut-off, 3.73 ng/mL), that for CRP was 0.72 (sensitivity, 75.0%; specificity, 64.6%; optimum cut-off, 0.14 mg/dL), and for WBC it was 0.44 (sensitivity, 60.0%; specificity, 29.6%; optimum cut-off, 15,000 cells/µL). CONCLUSIONS: PCT is more susceptible, as a diagnostic parameter of infection, to the effect of respiratory disturbance than CRP and WBC.


Assuntos
Biomarcadores/sangue , Calcitonina/sangue , Transtornos Respiratórios/diagnóstico , Proteína C-Reativa/metabolismo , Feminino , Humanos , Recém-Nascido , Contagem de Leucócitos , Medições Luminescentes , Masculino , Curva ROC , Sensibilidade e Especificidade
13.
Genes Chromosomes Cancer ; 53(1): 78-89, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24142740

RESUMO

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a subtype of acute myeloid leukemia, affecting mainly the elderly. It is thought to be derived from plasmacytoid dendritic cell precursors, which frequently present as cutaneous lesions. We have made a detailed analysis of an infant with BPDCN, who manifested with hemophagocytic lymphohistiocytosis. The peripheral blood leukocytes revealed the t(2;17;8)(p23;q23;p23) translocation and a CLTC-ALK fusion gene, which have never been reported in BPDCN or in any myeloid malignancies thus far. Neonatal blood spots on the patient's Guthrie card were analyzed for the presence of the CLTC-ALK fusion gene, identifying the in utero origin of the leukemic cell. Although the leukemic cells were positive for CD4, CD56, CD123, and CD303, indicating a plasmacytoid dendritic cell phenotype, detailed analysis of the lineage distribution of CLTC-ALK revealed that part of monocytes, neutrophils, and T cells possessed the fusion gene and were involved in the leukemic clone. These results indicated that leukemic cells with CLTC-ALK originated in a multipotent hematopoietic progenitor in utero. This is the first report of the CLTC-ALK fusion gene being associated with a myeloid malignancy, which may give us an important clue to the origin of this rare neoplasm.


Assuntos
Células Dendríticas/patologia , Leucemia Mieloide Aguda/genética , Proteínas de Fusão Oncogênica/genética , Cromossomos Humanos Par 2/genética , Feminino , Fusão Gênica , Humanos , Lactente , Leucemia Mieloide Aguda/congênito , Leucemia Mieloide Aguda/patologia
14.
Kansenshogaku Zasshi ; 89(3): 369-74, 2015 May.
Artigo em Japonês | MEDLINE | ID: mdl-26552128

RESUMO

We examined staphylococcal coagulase types and homologous analysis using the DiversiLab repetitive-sequence-based PCR system in exfoliative toxin (ET)-producing Staphylococcus aureus. Twenty-two isolates (17 methicillin-sensitive Staphylococcus aureus (MSSA) and 5 methicillin-resistant Staphylococcus aureus (MRSA) isolates) obtained in our hospital from January 2012 and December 2013 were used. Three groups were classified according to the coagulase types and serotypes of ET. The first group (4 MSSA) showed coagulase type I and ET-A, and the second group (3 MSSA and 2 MRSA) showed coagulase type I and ET-B. The third group (10 MSSA and 3 MRSA) showed coagulase type V and ET-B. An analysis by DiversiLab demonstrated that homology was high in both the first and second groups. The homogenousness was high among the third group isolates except for the ocular isolates. In our hospital, three important groups were present according to a coagulase type and an ET type, and the homology of ocular isolates could be different from other materials isolates.


Assuntos
Exfoliatinas/biossíntese , Reação em Cadeia da Polimerase/métodos , Sequências Repetitivas de Ácido Nucleico , Staphylococcus aureus/isolamento & purificação , Coagulase/análise , Humanos , Resistência a Meticilina/genética , Staphylococcus aureus/genética , Staphylococcus aureus/metabolismo
15.
Pediatr Blood Cancer ; 61(10): 1860-6, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24976435

RESUMO

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curable approach for myelodysplastic syndrome (MDS) and myeloproliferative neoplasms (MPN); however, the event-free survival rate of patients with pediatric MDS and MPN is still only approximately 60%. Although salvage HSCT is the only curative approach for patients with the failure of previous HSCT, its safety and efficacy have yet to be determined. PROCEDURES: We retrospectively analyzed 51 pediatric MDS or MPN who received salvage HSCT for relapse or graft failure following HSCT using registry data of the Japan Society for Hematopoietic Cell Transplantation. The indications used for salvage HSCT were relapse in 22 patients and graft failure in 29 patients. RESULTS: The overall survival (OS) rate for salvage HSCT in relapsed patients was 49.0 ± 10.8% at 3 years. The cumulative incidence of relapse following salvage HSCT was 29.8 ± 10.7% at 3 years, whereas the incidence of non-relapse mortality (NRM) was 28.6 ± 10.2%. No significant differences were observed in the OS after salvage HSCT between disease types. Twenty-four of 29 patients who received salvage HSCT for graft failure achieved engraftment, resulting in an engraftment probability of 81.5 ± 8.0% on day 100. The OS rate after salvage HSCT for graft failure was 56.8 ± 9.6% at 3 years. CONCLUSIONS: Second HSCT should be considered as a valuable option for the patients with relapse and graft failure in patients with pediatric MDS or MPN after HSCT, but high NRM is an important issue that needs to be addressed.


Assuntos
Transplante de Células-Tronco Hematopoéticas/métodos , Transtornos Mieloproliferativos/cirurgia , Terapia de Salvação/métodos , Adolescente , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Transplante de Células-Tronco Hematopoéticas/mortalidade , Humanos , Lactente , Recém-Nascido , Estimativa de Kaplan-Meier , Masculino , Transtornos Mieloproliferativos/mortalidade , Recidiva Local de Neoplasia/cirurgia , Estudos Retrospectivos , Terapia de Salvação/mortalidade , Transplante Homólogo
16.
Pediatr Hematol Oncol ; 31(6): 528-33, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24684413

RESUMO

Subcutaneous panniculitis-like T-cell lymphoma (SPTL) is a rare type of skin lymphoma. Histopathology mimicking a lobular panniculitis makes it difficult to distinguish SPTL from benign autoimmune disease. We present cases of a 10-year-old female and an 11-year-old male with SPTL showing recurrent panniculitis and systemic manifestations. Initially, antibiotics and steroids were administered to treat infectious disease and benign panniculitis. However, they experienced recurrent fever and erythema nodosum. Additional immunohistochemistry and T-cell receptor (TCR) gene rearrangement analyses were performed, enabling the establishment of an SPTL diagnosis. The affected patients were given immunosuppressive therapy with favorable results.


Assuntos
Imunossupressores/administração & dosagem , Linfoma de Células T/diagnóstico , Linfoma de Células T/tratamento farmacológico , Paniculite/diagnóstico , Paniculite/tratamento farmacológico , Criança , Estudos de Coortes , Feminino , Humanos , Linfoma de Células T/imunologia , Linfoma de Células T/cirurgia , Masculino , Paniculite/imunologia , Paniculite/cirurgia , Fatores de Risco
17.
Eur J Pediatr ; 172(10): 1419-21, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23440482

RESUMO

UNLABELLED: Recent findings have focused on the possible role of linezolid (LZD) as a suitable candidate for the treatment of central nervous system infections. LZD treatment for meningitis has been sporadically reported in adults, but there are no reports in neonates or infants. We report a case of meningitis caused by methicillin-resistant Staphylococcus epidermidis (MRSE) in a neonatal girl. The patient had intraventricular hemorrhage on postnatal day 1 and was treated with ventricular drainage. Twenty-two days after drainage, the patient developed a fever and seizure. Although ampicillin and ceftriaxone were given empirically for meningitis, an increased cell count and protein were observed in cerebrospinal fluid (CSF). Vancomycin (VCM) was administered intravenously because MRSE was detected from CSF 2 days after the administration of ampicillin and ceftriaxone. However, intravenous administration of VCM did not show any effect. Subsequent treatment of LZD successfully reduced the cell count and protein in CSF. CONCLUSION: LZD may be a treatment option for neonates and infants for drain-associated meningitis caused by MRSE.


Assuntos
Acetamidas/uso terapêutico , Anti-Infecciosos/uso terapêutico , Meningites Bacterianas/tratamento farmacológico , Resistência a Meticilina , Oxazolidinonas/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus epidermidis/efeitos dos fármacos , Feminino , Humanos , Recém-Nascido , Linezolida , Resultado do Tratamento
19.
Case Rep Pediatr ; 2023: 4374552, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37180286

RESUMO

Background: In this study, we report the case of a 14-month-old female patient transferred from another hospital to our hospital with a 9-day history of fever and worsening dyspnea. Case Report. The patient tested positive for influenza type B virus 7 days before being transferred to our hospital but was never treated. The physical examination performed at presentation revealed redness and swelling of the skin at the site of the peripheral venous catheter insertion performed at the previous hospital. Her electrocardiogram revealed ST segment elevations in leads II, III, aVF, and V2-V6. An emergent transthoracic echocardiogram revealed pericardial effusion. As ventricular dysfunction due to pericardial effusion was not present, pericardiocentesis was not performed. Furthermore, blood culture revealed methicillin-resistant Staphylococcus aureus (MRSA). Thus, a diagnosis of acute pericarditis complicated with sepsis and peripheral venous catheter-related bloodstream infection (PVC-BSI) due to MRSA was made. Frequent bedside ultrasound examinations were performed to evaluate the outcomes of the treatment. After administering vancomycin, aspirin, and colchicine, the patient's general condition stabilized. Conclusions: In children, it is crucial to identify the causative organism and provide appropriate targeted therapy to prevent worsening of the condition and mortality due to acute pericarditis. Moreover, it is important to carefully monitor the clinical course for the progression of acute pericarditis to cardiac tamponade and evaluate the treatment outcomes.

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