RESUMEN
During a blood test, the discovery of thrombocytosis is a frequent phenomenon with multiple origins. False thrombocytosis linked to analytical interferences is rare but must be eliminated before confirming the anomaly. The reaction origin, often very easily demonstrated by the context and/or the presence of a biological inflammatory syndrome, is the most frequent. More rarely, the diagnosis is oriented towards a clonal hematological pathology not limited to essential thrombocythemia. Currently, many biological tools, which have largely contributed to the recommendations of the latest WHO classification of chronic myeloid neoplasms, are available to classify these pathologies as precisely as possible, allowing optimal management.
Asunto(s)
Trastornos Mieloproliferativos , Trombocitemia Esencial , Trombocitosis , Adulto , Humanos , Trombocitemia Esencial/diagnóstico , Trombocitosis/diagnósticoRESUMEN
The discovery of eosinophilia above 1.5 G/L should not be considered innocuous, requiring monitoring for etiology and possible secondary organ damage. Among these, cardiac localization is the most worrying, sometimes indolent, to be systematically sought by ultrasound and magnetic resonance. The potential etiologies are very numerous, mostly reactive and corticosensitive, much more rarely clonal in relation to a malignant hemopathy usually chronic and myeloid, sometimes sensitive to tyrosine kinase inhibitors.
Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Eosinofilia/diagnóstico , Eosinofilia/etiología , Pruebas Hematológicas/métodos , Técnicas de Laboratorio Clínico/historia , Técnicas de Laboratorio Clínico/normas , Diagnóstico Diferencial , Eosinofilia/historia , Pruebas Hematológicas/historia , Pruebas Hematológicas/normas , Historia del Siglo XXI , HumanosRESUMEN
Immunosuppression is a well known risk factor for the development of lymphoid pathologies. The classification of these neoplasias is becoming more precise and complex, some features being common to all immunocompromised patients, primarily the important influence of Epstein-Barr virus. Whatever the origin of the immunodepression, these lymphoid proliferations are very heterogeneous, constituting a wide range between polymorphic aspects and clearly lymphomatous morphologies indistinguishable from those observed in immunocompetent subjects. It is important to detect precisely these different categories of proliferation within each group of immunosuppression, to better individualize the prognosis and the management of patients.
Asunto(s)
Huésped Inmunocomprometido , Linfoma/etiología , Transformación Celular Viral/fisiología , VIH/fisiología , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Infecciones por VIH/inmunología , Infecciones por VIH/patología , Humanos , Huésped Inmunocomprometido/inmunología , Síndromes de Inmunodeficiencia/complicaciones , Síndromes de Inmunodeficiencia/epidemiología , Inmunosupresores/efectos adversos , Linfoma/epidemiología , Linfoma/inmunología , Trastornos Linfoproliferativos/inducido químicamente , Trastornos Linfoproliferativos/epidemiología , Trastornos Linfoproliferativos/inmunología , Trasplante de Órganos/efectos adversos , Trasplante de Órganos/estadística & datos numéricos , Acondicionamiento Pretrasplante/efectos adversos , Acondicionamiento Pretrasplante/estadística & datos numéricosRESUMEN
The discovery of a monocytosis is a frequent phenomenon, requiring confirmation by reading under a microscope by an experimented biologist, to overcome usual cytological traps such as the presence of hairy cells, promonocytes or monoblasts. In the vast majority of cases the secondary origin is very easily found by the context and/or the presence of a biological inflammatory syndrome. More rarely the diagnosis is directed towards an eosinophilic pathology or an acute leukemia. In other cases, CMML, MPN or MDS with monocytosis may be highlighted. In the absence of any pathognomonic element and the presence of "borderline" forms the differential diagnosis between these 3 entities is not always straightforward, requiring, according to WHO, molecular investigations and elimination of any reactive cause of monocytosis. Although histological, immunohistochemical and phenotypic flow cytometric studies are not currently recommended by WHO, these investigations could be of interest in the evaluation of difficult cases.
Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Monocitos/patología , Síndromes Mielodisplásicos/diagnóstico , Adulto , Edad de Inicio , Algoritmos , Diagnóstico Diferencial , Humanos , Recuento de Leucocitos , Síndromes Mielodisplásicos/epidemiología , Síndromes Mielodisplásicos/patologíaRESUMEN
The etiological assessment of a monoclonal gammopathy is currently standardized, the decisional algorithms allowing a sufficiently precise classification to consider the care, wait or therapeutic. The purpose of this review is to recall the difficulties concerning the interpretation of certain biological investigations and to point out the potential complications of monoclonal gammopathies labeled as "benign". The cooperation between clinicians and biologists is in all cases essential, allowing to propose on a case-by-case basis the best adapted explorations.
Asunto(s)
Servicios de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico , Gammopatía Monoclonal de Relevancia Indeterminada/diagnóstico , Gammopatía Monoclonal de Relevancia Indeterminada/etiología , Toma de Decisiones Clínicas , Técnicas de Laboratorio Clínico/normas , Técnicas de Laboratorio Clínico/estadística & datos numéricos , Exactitud de los Datos , Interpretación Estadística de Datos , Diagnóstico Diferencial , Humanos , Gammopatía Monoclonal de Relevancia Indeterminada/complicacionesAsunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Mieloma Múltiple/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Dexametasona/administración & dosificación , Esquema de Medicación , Femenino , Humanos , Estimación de Kaplan-Meier , Lenalidomida/administración & dosificación , Masculino , Persona de Mediana Edad , Oligopéptidos/administración & dosificación , Supervivencia sin Progresión , Recurrencia , Terapia RecuperativaRESUMEN
Adult neutropenia, defined as a blood neutrophil count below 1.5 G/L, is a common condition. The most common cause of acute neutropenia is a drug-related reaction or an acute infectious disease. In chronic forms many etiologies are possible, sometimes poorly-defined, requiring precise explorations. The purpose of this article is to recall the required criteria for exploring neutropenia and to point out the algorithm of explorations in order to find the cause. Etiologies of acute and chronic forms are also detailed.
Asunto(s)
Neutropenia/diagnóstico , Neutropenia/etiología , Adulto , Edad de Inicio , Lista de Verificación , Diagnóstico Diferencial , Humanos , Neutropenia/epidemiología , Factores de RiesgoRESUMEN
We report 2 cases of Agrobacterium radiobacter bacteremia in immunocompromised patients. Removal of the central venous catheter and administration of antimicrobial therapy led to favorable outcomes in both patients. Infections due to A. radiobacter are rare and usually occur in patients with predisposing factors.