Anti-PF4 ELISA-Negative, SRA-Positive Heparin-Induced Thrombocytopenia.

Heparin products are frequently used in the inpatient setting to prevent and treat venous thromboembolism, but they simultaneously put patients at risk of developing heparin-induced thrombocytopenia (HIT). The 4Ts score determines the pretest probability of HIT. Diagnosis is made with a screening antiplatelet factor (PF4) immunoassay and the serotonin-release assay (SRA) as a confirmatory test.

Cyclic Thrombocytopenia in the Setting of Intracranial Hemorrhage: A Diagnostic and Therapeutic Challenge.

Cyclic thrombocytopenia (CTP) as the name suggests presents with cyclic episodes of thrombocytopenia and is frequently initially misdiagnosed as immune thrombocytopenia. Following a lack of sustained response or abnormally increased response to common treatments used for immune thrombocytopenia, a proper diagnosis of CTP can then be made. Prior reports have shown a subset of patients who respond to cyclosporin A.

Methemoglobinemia in the Setting of G6PD Deficiency and SARS-CoV-2 Infection.

catalyzes the pentose phosphate shunt. It is required to maintain the level of nicotinamide adenine dinucleotide We report a case of a 58 year old African American male patient with Coronavirus Disease-2019 (COVID-19) in the setting of multiple concomitant hematologic disorders, including Glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency) and sickle cell trait. Typically, G6PD deficiency remains clinically silent, and only a minority of patients will show signs of chronic hemolytic anemia.

Rare presentation of enoxaparin-induced skin necrosis in a postoperative patient.

Enoxaparin-induced skin necrosis is a rare complication of low-molecular weight heparin (LMWH) therapy. We describe a woman in her 50s who developed deep vein thrombosis (DVT), thrombocytopenia and necrotic skin lesions after initiation of enoxaparin for DVT prophylaxis. Despite high clinical suspicion of heparin-induced thrombocytopenia syndrome and a positive heparin-platelet factor 4 antibody, heparin serotonin assay was negative.

Management of congenital dysfibrinogenemia in pregnancy: A challenging patient case.

Afibrinogenemia and congenital dysfibrinogenemia (CD) are rare conditions with limited information available for appropriate management. Previous case reports have demonstrated the safe and efficacious use of fibrinogen replacement therapy (FRT) as a therapeutic approach to prevent hemorrhage and fetal loss in pregnant women with CD. In this case report, we present a 28-year-old pregnant woman who sought testing for CD given her family history.

Schnitzler's Syndrome: A Diagnostic Consideration in Evaluating the Constellation of Monoclonal Gammopathy and Chronic Urticaria.

Schnitzler's syndrome is a rare clinical entity characterized by intermittent, non-pruritic urticarial rash, fevers, arthralgias, myalgias and monoclonal gammopathy, most commonly of the immunoglobulin M (IgM) subtype. Schnitzler's syndrome should be considered in the differential diagnosis of fever of unknown origin. We report a case of a 56-year-old healthy Caucasian female, who initially presented to the primary care physician's office with complaints of severe generalized fatigue and myalgias involving thighs and calves.

Fine-needle aspiration cytology of disseminated Kaposi sarcoma of the bone in an AIDS patient.

Background: Kaposi sarcoma (KS) is a vascular neoplasm associated with human herpesvirus 8 (HHV-8). Skin and mucous membranes are the most common sites, but other organs may be involved. Skeletal KS is rare and occurs either by direct spread of mucocutaneous lesions or through dissemination.

A vocabulary for the identification and delineation of teratoma tissue components in hematoxylin and eosin-stained samples.

Unlabelled: We propose a methodology for the design of features mimicking the visual cues used by pathologists when identifying tissues in hematoxylin and eosin (H&E)-stained samples.

Background: H&E staining is the gold standard in clinical histology; it is cheap and universally used, producing a vast number of histopathological samples. While pathologists accurately and consistently identify tissues and their pathologies, it is a time-consuming and expensive task, establishing the need for automated algorithms for improved throughput and robustness.

Local histograms and image occlusion models.

The local histogram transform of an image is a data cube that consists of the histograms of the pixel values that lie within a fixed neighborhood of any given pixel location. Such transforms are useful in image processing applications such as classification and segmentation, especially when dealing with textures that can be distinguished by the distributions of their pixel intensities and colors. We, in particular, use them to identify and delineate biological tissues found in histology images obtained via digital microscopy.

A domain-knowledge-inspired mathematical framework for the description and classification of H&E stained histopathology images.

We present the current state of our work on a mathematical framework for identification and delineation of histopathology images-local histograms and occlusion models. Local histograms are histograms computed over defined spatial neighborhoods whose purpose is to characterize an image locally. This unit of description is augmented by our occlusion models that describe a methodology for image formation.

AUTOMATED COLITIS DETECTION FROM ENDOSCOPIC BIOPSIES AS A TISSUE SCREENING TOOL IN DIAGNOSTIC PATHOLOGY.

We present a method for identifying colitis in colon biopsies as an extension of our framework for the automated identification of tissues in histology images. Histology is a critical tool in both clinical and research applications, yet even mundane histological analysis, such as the screening of colon biopsies, must be carried out by highly-trained pathologists at a high cost per hour, indicating a niche for potential automation. To this end, we build upon our previous work by extending the histopathology vocabulary (a set of features based on visual cues used by pathologists) with new features driven by the colitis application.

AUTOMATIC IDENTIFICATION AND DELINEATION OF GERM LAYER COMPONENTS IN H&E STAINED IMAGES OF TERATOMAS DERIVED FROM HUMAN AND NONHUMAN PRIMATE EMBRYONIC STEM CELLS.

We present a methodology for the automatic identification and delineation of germ-layer components in H&E stained images of teratomas derived from human and nonhuman primate embryonic stem cells. A knowledge and understanding of the biology of these cells may lead to advances in tissue regeneration and repair, the treatment of genetic and developmental syndromes, and drug testing and discovery. As a teratoma is a chaotic organization of tissues derived from the three primary embryonic germ layers, H&E teratoma images often present multiple tissues, each of having complex and unpredictable positions, shapes, and appearance with respect to each individual tissue as well as with respect to other tissues.

Local Histograms for Classifying H&E Stained Tissues.

We introduce a rigorous mathematical theory for the analysis of local histograms, and consider the appropriateness of their use in the automated classification of textures commonly encountered in images of H&E stained tissues. We first discuss some of the many image features that pathologists indicate they use when classifying tissues, focusing on simple, locally-defined features that essentially involve pixel counting: the number of cells in a region of given size, the size of the nuclei within these cells, and the distribution of color within both. We then introduce a probabilistic, occlusion-based model for textures that exhibit these features, in particular demonstrating how certain tissue-similar textures can be built up from simpler ones.