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1.
Case Reports Immunol ; 2024: 6662652, 2024.
Article in English | MEDLINE | ID: mdl-38516555

ABSTRACT

There is growing evidence that infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to dysregulation of the immune system and, consequently, the development of autoimmune phenomena. Here, we describe the case of a 75-year-old woman with rheumatic manifestations characterized by intense musculoskeletal pain and stiffness in the neck and shoulders, with sudden onset and with the inability to raise her arms. The patient was admitted with severe pain located in the neck and shoulders. Previously, she had oropharyngeal pain, severe fatigue, and fever; a real-time polymerase chain reaction test for COVID-19 was positive. Two weeks later, the patient presented localized musculoskeletal pain in the neck and shoulders. Relevant laboratory results included an erythrocyte sedimentation rate of 46 mm/hr and a negative rheumatoid factor test; ultrasound findings with bilateral subacromial-subdeltoid bursitis were observed. A diagnosis of polymyalgia rheumatica (PMR) was initially made according to the EULAR/ACR provisional classification criteria for PMR; however, due to C-reactive protein negativity, the diagnosis was established based on symptoms. Management was with prednisone at the dose of 25 mg/day for 4 weeks and progressive reduction until prednisone suspension. The patient showed complete recovery at 6 months of follow-up. In this case, COVID-19 was implicated in the development of autoimmune and inflammatory rheumatic manifestations. PMR is a rare rheumatic condition that should be included in the wide range of rheumatologic manifestations expressed post-SARS-CoV-2 infection.

3.
Pediatr Blood Cancer ; 59(5): 950-2, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22434694

ABSTRACT

Haploidentical hematopoietic cell transplantation using CD34(+) cells depleted of T lymphocytes by the CliniMACS is a treatment for hematological malignancy. We report on four Mexican children, three with acute lymphocytic leukemia and one with chronic myelocytic leukemia, who was transplanted with 12 × 10(6) CD34(+) stem cells/kg body weight (98% of purity) with a follow-up of 9½ years. The engraftment was successful in three of the four children. All showed cytomegalovirus reactivation, and one died because of graft rejection and infectious complication. The risk of infections was a major problem.


Subject(s)
Bone Marrow Transplantation , Hematopoietic Stem Cell Transplantation , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Adolescent , Child, Preschool , Female , Follow-Up Studies , Graft Rejection , Graft Survival , Histocompatibility Testing , Humans , Male , Mexico , Transplantation, Homologous
4.
Cir Cir ; 80(5): 455-8, 2012.
Article in Spanish | MEDLINE | ID: mdl-23351451

ABSTRACT

BACKGROUND: Acute lymphoblastic leukemia initially shows osteoarticular manifestations. However, it is rare that it shows juvenile idiopathic arthritis (JIA) symptoms. CLINICAL CASE: A child with acute lymphoblastic leukemia initially misdiagnosed with malignant neoplasia and septic arthritis, and later on with juvenile idiopathic arthritis. The child had persistent articular pain and swelling despite treatment. Six months later, a full blood count revealed leukopenia and neutropenia with lymphocytosis. A bone marrow aspirate confirmed pre-B acute lymphoblastic leukemia with hypodyploidia. CONCLUSION: This case initially showed typical signs of arthritis, and a diagnosis of acute lymphoblastic leukemia was ruled out, since the those clinical features and hematologic alterations characterizing this hematologic neoplasia.


Subject(s)
Arthritis/etiology , Diagnostic Errors , Paraneoplastic Syndromes/etiology , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/complications , Aneuploidy , Arthritis, Infectious/diagnosis , Arthritis, Juvenile/diagnosis , Blood Cell Count , Bone Marrow/pathology , Child , Delayed Diagnosis , Disease Progression , Elbow Joint/pathology , Female , Humans , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/blood , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/pathology
5.
Bol. méd. Hosp. Infant. Méx ; 56(11): 609-11, nov. 1999. graf
Article in Spanish | LILACS | ID: lil-266513

ABSTRACT

Introducción. El trasplante autólogo de médula ósea es un arma terapéutica útil en diferentes neoplasias hematológicas y tumores sólidos. Se reporta el caso de un paciente sometido a trasplante de células progenitoras hematopoyéticas de sangre periférica (CPSP) realizado en el Hospital Infantil de México Federico Gómez. Caso clínico. Paciente de 3 años de edad con diagnóstico de tumor de Wilms estadio IV inicia, que después de una primera remisión completa, presentó recaída a los 8 meses a pulmón y sistema nervioso central. El paciente recibió tratamiento de rescate con ifosfamida, VP16 y Ara-C, radioterapia a cráneo con 60 cGy y abordaje quirúrgico de 2 lesiones residuales pulmonares. El paciente se consideró en segunda remisión completa y se realizó movilización de CPSP con ciclofosfamida 4 g/m² de superficie corporal (SC) co MESNA 4 g/m² SC y factor estimulante de granulocitos 19 µg/kg de peso corporal. Después de la recolección de CPSP mediante aféresis, se administraron altas dosis de quimioterapia con melfalán 45 mg/m² SC por 4 días, VP16 40 mg/kg una dosis, carboplatino 500 mg/m² SC por tres días, con rescate de células hematopoyéticas. El día 11 post-trasplante el paciente se recuperó en la cuenta de granulocitos y la plaquetaria fue mayor de 30,000/µL el día 34. Conclusión. El trasplante de médula ósea es la mejor alternativa terapéutica en pacientes con recaída de alto riesgo de tumor de Wilms


Subject(s)
Humans , Male , Child, Preschool , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cell Transplantation/statistics & numerical data , Wilms Tumor , Treatment Outcome
6.
Bol. méd. Hosp. Infant. Méx ; 56(10): 571-81, oct. 1999. tab
Article in Spanish | LILACS | ID: lil-266506

ABSTRACT

El trasplante de médula ósea es actualmente un procedimiento de rutina en el tratamiento de tumores sólidos, neoplasias hematológicas, enfermedades adquiridas no malignas y padecimientos congénitos. Este tipo de tratamiento permite remisiones y sobrevidas a largo plazo entre 50 a 90 por ciento de los casos en general y dependiendo del tipo de padecimiento, las condiciones del enfermo y el estadio de enfermedad habitualmente mortales. El conocimiento cada vez más detallado de la biología de las células hematopoyéticas, la posibilidad de recolectarlas de la sangre periférica mediante procedimientos de eféresis y la facilidad de movilizarlas mediante quimioterpia y factores estimulantes de colonias, permite cada vez mejores resultados y hace el trasplante más sencillo. Por otro lado, el establecimiento de rutinas de profilaxis y tratamiento agresivos contra procesos infecciosos, ha permitido el abatimiento de la morbi-mortalidad peritrasplante aún en pacientes con inmunocompromiso grave, secundario a trasplante alogénico de médula ósea y enfermedad de injerto contra huésped


Subject(s)
Humans , Bone Marrow Transplantation , Diagnosis, Differential , Graft vs Host Disease/classification , Graft vs Host Disease/therapy , Risk Factors
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