Effects of intravenous iron saccharate on improving severe anemia in rheumatoid arthritis patients.

Anemia in rheumatoid arthritis (RA) is multifactorial. Iron deficiency, either definite or relative (defect in iron utilization), exists in RA patients with anemia. Intravenous iron therapy is indicated in severe and symptomatic cases or those with conditions precluding use of oral iron, but its safety and long-term efficacy have not been well-established.

Can very high level of D-dimer exclusively predict the presence of thromboembolic diseases?

Background: D-dimer quantitative test is mainly used to rule out the presence of thromboembolic diseases (TEDs). Whether very high D-dimer (100 times above the cutoff point) can exclusively indicate the presence of TED should be known.

Methods: D-dimer was detected by a quantitative immunoturbidimetric assay.

The prevalence of iron deficiency anemia and its clinical implications in patients with colorectal carcinoma.

Background: Gastrointestinal (GI) tract malignancy is an important cause of chronic iron deficiency anemia (IDA). The present study was designed to determine the prevalence of IDA and its clinical implications in colorectal cancer patients.

Methods: We performed a retrospective study of 101 patients who were admitted to Taipei Veterans General Hospital with proven colorectal carcinoma from 2003-2005.

Combined treatment with splenectomy and cladribine in hairy cell leukemia in Taiwan: a clinicopathologic study of 5 cases.

Background: Hairy cell leukemia (HCL) is a rare B-cell lymphoid malignancy that is characterized by the presence of hairy cells in the peripheral blood and bone marrow, pancytopenia and various degrees of splenomegaly. Very few reports have explored the clinicopathologic features and treatment outcome of HCL in Taiwan.

Methods: Of 33 patients with malignant lymphoma who underwent splenectomy over a 10-year period (1996-2005), 5 cases of HCL were retrospectively studied.

Complex karyotypes confer a poor survival in adult acute myeloid leukemia with unfavorable cytogenetic abnormalities.

Cytogenetics represents the most valuable predictor for a poor outcome in patients with acute myeloid leukemia (AML), but it encompasses a heterogeneous patient population who might have diverse pathogenesis and clinical courses. In particular, the significance of complex chromosome aberrations within this cohort has seldom been addressed before. We analyzed 48 AML patients with adverse-risk cytogenetics in this study.

Unappreciated HLA antibodies in adult immune thrombocytopenic purpura.

Background/purpose: Immune thrombocytopenic purpura (ITP) is an autoimmune disease. Platelet refractoriness is frequently seen in patients with ITP. Platelets express platelet-specific antigens and human leukocyte antigens (HLA).

Screening for platelet antibodies in adult idiopathic thrombocytopenic purpura: a comparative study using solid phase red cell adherence assay and flow cytometry.

Background: Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder caused by antiplatelet autoantibodies. In this study, we compared 2 methods for screening serum platelet antibodies in patients with ITP.

Methods: A total of 44 adult patients were clinically classified with ITP.

Nucleotide changes around the splicing acceptor of intron 24 in the factor VIII gene and its impact on splicing.

Nucleotide 6724 of the factor VIII gene harbors a polymorphism of low frequency. A report from Taiwan claimed that 97.9% of the 83 alleles examined were of the A nucleotide at this position, which is quite different to the data from Western populations.

Treatment outcomes in patients receiving conventional amphotericin B therapy: a prospective multicentre study in Taiwan.

Objectives: To evaluate treatment outcomes and healthcare resource use with conventional amphotericin B therapy for invasive fungal infections (IFIs).

Patients And Methods: A prospective observational study in hospitalized adult patients receiving amphotericin B treatment was undertaken at four hospitals in Taiwan. Patients were observed from the start of therapy to hospital discharge.

Influence of methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism, B vitamins and other factors on plasma homocysteine and risk of thromboembolic disease in Chinese.

Background: Thromboembolic disease is a major cause of morbidity and mortality in many countries. Our previous study found that Chinese subjects carried the same polymorphism of the methylenetetrahydrofolate reductase (MTHFR) gene as described in Western studies. The aim of the present study was to determine the influence of MTHFR polymorphism, B vitamins and other factors on plasma homocysteine (Hcy) levels and risk of thromboembolic disease in Chinese.

Plasma antigen levels of thrombin-activatable fibrinolysis inhibitor did not differ in patients with or without disseminated intravascular coagulation.

Thrombin-activatable fibrinolysis inhibitor (TAFI) is a carboxypeptidase that downregulates fibrinolysis and might play some roles in the pathogenesis of disseminated intravascular coagulation (DIC). We prospectively examined the plasma TAFI antigen levels in patients highly suspected to be suffering from DIC. Patients were subdivided into overt DIC and non-DIC groups according to a DIC scoring system.

Predictive risk factors and prevalence of malignancy in patients with iron deficiency anemia in Taiwan.

Gastrointestinal (GI) tract malignancy is one of the important causes of chronic iron deficiency anemia (IDA). The present study was designed to find out the prevalence and the predictive risk factors of malignancy in the IDA patients. We performed a prospective study in 148 patients with chronic IDA.

Donor lymphocyte infusion induced acute hepatitis.

Hepatic graft-versus-host disease (GVHD) post allogeneic hematopoietic stem cell transplantation generally presents as cholestatic jaundice and increased serum alkaline phosphatase (ALK-P). Currently accepted standards for evaluating the clinical severity of hepatic GVHD are not based on serum aminotransferase levels but on the serum bilirubin levels. We describe a 25-year-old female who initially had no liver damage at all after an allogeneic peripheral blood stem cell transplantation (allo-PBSCT) from her HLA-indentical sister.

White blood cell and platelet counts could affect whole blood viscosity.

Background: Blood viscosity is correlated with cerebral blood flow and cardiac output, and increased viscosity may increase the risk of thrombosis or thromboembolic events. The relationship between hematocrit and viscosity is well-known, however, the relationships between white blood cell (WBC) or platelet count and viscosity were not fully studied. The aim of the present study was to determine the influences of platelet count and WBC count on blood viscosity.

The aPTT assay as a monitor of heparin anticoagulation efficacy in clinical settings.

Activated partial thromboplastin time (aPTT) and prothrombin time (PT) are 2 major methods of screening patients for bleeding tendency. Heparin is an anticoagulant commonly used for various clinical conditions and will thus affect the coagulation profile. The influence of heparin on PT vs aPTT, seldom addressed in the past, should be carefully investigated.

Rapid detection of intron 22 inversions of the factor VIII gene in Chinese patients with severe hemophilia A.

Background: Hemophilia A is caused by mutations in the gene for coagulation factor VIII. Recently, it has been reported that about half of the patients with severe hemophilia A have a large genomic inversion of the factor VIII gene. We tried to use a rapid method to detect this important mutation in the Chinese hemophiliacs.

Aggressive multiple myeloma with brain involvement in a young patient.

Multiple myeloma is generally a neoplastic plasma cell disorder of the old age. It seldom attacked young people or manifested intracranial plasmacytomas. Here we report a 28-year-old young patient of plasma cell dyscrasia who presented multiple plasmacytomas of bones while sparing bone marrow.

Variations of prothrombin time and international normalized ratio in patients treated with warfarin.

Prothrombin time is a standard screening test to monitor patients treated with oral anticoagulants. We hypothesize that INR measurements will not vary a lot within a given day in a given patient. The present study was thus conducted to compare the change of the international normalized ratio (INR) of prothrombin time (PT) within 1 day in patients treated with warfarin.

Aggressive undifferentiated carcinoma of unknown primary site complicated by lactic acidosis after bleeding: a case report.

Undifferentiated carcinoma of unknown primary site complicated by lactic acidosis has not been documented. We describe a young female with undifferentiated carcinoma of unknown primary site manifested by widespread lymph node and hepatic infiltration, hyperuricemia and very high levels of lactate dehydrogenase. She developed lactic acidosis suddenly after an episode of bleeding following nasal biopsy.

The diagnostic role of serum transferrin receptor in patients with various anemia.

Background: Serum ferritin is known as a good tool to diagnose iron status. Recently the soluble serum transferrin receptor (sTfR) has been introduced as a promising new tool for diagnosing iron depletion. The present study was to compare the differential diagnostic values of sTfR and other related parameters in different causes of anemia.