RESUMEN
It appears that delayed hemolytic transfusion reactions may occur several days after the administration of donor red cells is true even though they have been shown to be compatible in cross match tests by the antiglobulin technique. A specific case was observed in our center, which confirms the fact. The patient was a 37-year-old male suffering from intermediate ß-thalassemia. He had a history of two previous transfusions, with unknown transfusion reaction. In the last transfusion, laboratory data showed: Hb 7.8 g/dL and Hematocrit (Hct) 24.2%. The patient received two units of cross matched, compatible concentrated red blood cells (RBCs). After eight days a severe reaction was observed with clinical evidence of tachycardia, fatigue, fever, back pain, chest discomfort, jaundice, nausea and anorexia. Accordingly delayed hemolytic transfusion reaction was suspected, and anti-RBC antibodies were tested. Laboratory tests revealed the presence of three alloantibodies: Anti-N, anti-S, anti-K, and a monospecific autoanti-JK(b).
RESUMEN
BACKGROUND AND AIM: In recent years, there has been considerable interest in whether vitamin D inhibits breast cancer development. Experimental studies have shown that vitamin D promotes cell differentiation and retards or terminates proliferation of breast cancer cells. However, there is little evidence supporting the association of vitamin D and prognosis of breast cancer. METHODS AND MATERIALS: In this analytic-descriptive study, 119 female patients with histological proven breast cancer were recruited in Tabriz oncology clinics in a 15-month period of time. History of chemotherapy, radiotherapy or receiving vitamin D/Ca supplements and presence of other malignancies were exclusion criteria. Serum level of 25 hydroxy vitamin D (25(OH)D) was measured in all patients. RESULTS: One hundred and nineteen patients with a mean age of 50.4∓12.6 (26-76) years were enrolled in the study. Metastasis was present in 21.8% of the cases. Stage of tumor was I, II, III and IV in 11, 56, 26 and 26 patients, respectively. The Tumor grade was low in 37 cases, intermediate in 46 cases, and high in 36 cases. The P53, Ki-67, HER2, ER and PR were positive in 30.3%, 49.6%, 17.6%, 61.2% and 55.5% of the patients, respectively. The mean serum level of 25(OH)D was 15.7∓17.8 (4-122) ng/ml, deficient in 66 cases, insufficient in 36 cases and normal level in 17 cases. The median level of 25(OH)D was lower in the P53+ group in a borderline trend (17.3 vs. 13.6 ng/ml; p=0.07). The median level of 25(OH)D was significantly higher in the patients with metastasis, as well (27.7 vs. 12.0 ng/ml; p=0.03). There was no significant association between the serum level of 25(OH)D and other studied parameters. CONCLUSION: Based on our findings, there may be an association between the serum level of 25(OH)D and prognosis of breast cancer.
