ABSTRACT
INTRODUCTION: Hodgkin's lymphoma (HL) is less common than non-Hodgkin lymphoma and is rarely associated with autoimmune cytopenia. METHOD: We report a consecutive, monocentric and retrospective series of HL patients diagnosed with concomitant or subsequent autoimmune cytopenia over a period of 8 years. RESULTS: We report 4 out of 84 HL patients (4.8%) diagnosed with autoimmune cytopenia (4 immune thrombocytopenia including 2 Evans' syndromes). They were 4 males (average age 24 years for the 3 youngest, and one over 60 years old). Autoimmune cytopenia revealed lymphoma in 2 patients and occurred after HL treatment in the two other patients (5 and 36 months from the end of chemotherapy) without HL relapse. All cytopenias were resistant to conventional treatments (glucocorticoids, intravenous immune globulin, rituximab) and sensitive to chemotherapy when indicated for HL treatment. CONCLUSION: In our series, the predominance of males, a higher frequency of immune thrombocytopenia than autoimmune hemolytic anemia, the resistance to usual treatments and the efficacy of specific chemotherapy were consistent with the literature. Unexpectedly, patients were young and with nodular sclerosis morphology (vs. mixed cellularity) in 3 of 4 cases.
Subject(s)
Anemia, Hemolytic, Autoimmune/complications , Anemia, Hemolytic, Autoimmune/diagnosis , Hodgkin Disease/complications , Hodgkin Disease/diagnosis , Purpura, Thrombocytopenic, Idiopathic/complications , Purpura, Thrombocytopenic, Idiopathic/diagnosis , Adolescent , Adult , Aged , Humans , Male , Retrospective Studies , Thrombocytopenia/complications , Thrombocytopenia/diagnosis , Young AdultABSTRACT
Immunoglobulin E (IgE) gammopathy is a rare disorder, accounting for just 0.1% of all patients with multiple myeloma (MM). Herein, we report a case of IgE monoclonal gammopathy without any biological and clinical symptoms, and we review 63 published cases in the literature. Demographic, biological and clinical presentations and features appear to be similar to those of other subtypes of MM, with a median age of diagnosis of 67years. There is a slight excess of male patients, and incidence seems to increase with age. The prevalence of renal failure, anaemia and hypercalcaemia at diagnosis was computed to be at 26%, 44% and 18%, respectively, in patients with MM. According to the literature, IgE MM is more aggressive and associated with poorer survival. Nonetheless, cases that are prolonged have also been described.
Subject(s)
Immunoglobulin E/blood , Paraproteinemias/blood , Adult , Aged , Aged, 80 and over , Electrophoresis, Capillary , Female , Humans , Male , Middle AgedABSTRACT
An outbreak of extended-spectrum ß-lactamase-producing Enterobacter cloacae (ESBL-ECL) occurred in our intensive care unit (ICU) and involved 18 patients (8 infected and 10 colonized). The mean age of patients was 69 years, and all infected patients had underlying medical conditions. Within hours' recognition of the spread of ESBL-ECL, the infection control team requested for staff education, reinforcement of infection control measures, and environmental screening. New transmissions were observed in the institution after weeks of enhanced infection control measures. Microbial swabbing revealed bacterial contamination of some mattresses and syphons with epidemiologic links between environmental, screening, and clinical isolates. This outbreak resulted in the temporary closure of the ICU for complete biocleaning.