RESUMO
Agranulocytosis is one of the most serious side effects to drugs. From January 1991 to June 1996 were diagnosed 19 cases of agranulocytosis associated with drugs at our hospital (incidence rate: 9.4 over million hab. per year). The average age was 62 and 11 cases were women. The drugs most commonly involved were metamizol and ticlopidine. In 15 of the patients fever blew up and 16 presented some infectious location. In 9 of the cases some positive microbiological culture was obtained, gram-negative bacilli being the commonest. G-CSF was used in 13 of the patients, observing a quicker haematological recovery (5.7 days vs 9.1, p = 0.07), though without any difference in mortality, which was of 0%. All this leads to the following conclusions: a high incidence of agranulocytosis in our environment and the important role of metamizol and ticlopidine in its origin.
Assuntos
Agranulocitose/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Agranulocitose/tratamento farmacológico , Dipirona/efeitos adversos , Feminino , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Ticlopidina/efeitos adversosRESUMO
We report two cases of hyperammonemic encephalopathy in patients with multiple myeloma. This rare complication, whose pathophysiology remains unknown, is associated with disease progression and so with a very bad prognosis. We believe that this complication should be included in the differential diagnosis of encephalopathy occurring in multiple myeloma.
Assuntos
Amônia/sangue , Encefalopatias/sangue , Encefalopatias/complicações , Mieloma Múltiplo/complicações , Delírio/etiologia , Delírio/metabolismo , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/patologia , Mieloma Múltiplo/fisiopatologiaAssuntos
Artrite Reumatoide/tratamento farmacológico , Líquido Sinovial/química , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Adulto , Idoso , Artrite Reumatoide/patologia , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Líquido Sinovial/efeitos dos fármacos , Triancinolona Acetonida/administração & dosagemRESUMO
Scedosporium prolificans is a filamentous fungus which has been recently identified as the aetiologic agent of severe infections in patients with haematological malignancies. Due to the resistance of S. prolificans to all known antifungals there are very few patients recovering from invasive infections. We describe the case of a patient with acute leukaemia who developed a S. prolificans pneumonia successfully treated with liposomal amphotericin B and who underwent autologous peripheral blood stem cells transplantation. The patient is in good health and has shown no evidence of reactivation of S. prolificans infection over one year after the transplant. Liposomal amphotericin B may be an effective treatment of pneumonia caused by S. prolificans in haematological patients.