Background: ABO blood type incompatibility hemolytic disease of newborn (ABO-HDN) and drug-induced immune hemolytic anemia (DIIHA) due to non-immunologic protein adsorption (NIPA) mainly cause extravascular hemolysis. All the reported severe DIIHA were caused by drug-induced antibodies, and rare report of acute intravascular hemolysis was caused by the NIPA mechanism or ABO-HDN.
Case Presentation: We report the first case of acute intravascular hemolysis induced by cefotaxime sodium - sulbactam sodium (CTX - SBT) in a case of ABO-HDN which resulted in death at 55 h after birth. The mother's blood type was O and RhD-positive, and the newborn's blood type was B and RhD-positive. No irregular red blood cell (RBC) antibodies or drug-dependent antibodies related to CTX or SBT was detected in the mother's plasma and the plasma or the RBC acid eluent of the newborn. Before the newborn received CTX - SBT treatment, the result of direct antiglobulin test (DAT) was negative while anti-B was positive (2 +) in both plasma and acid eluent. After the newborn received CTX - SBT treatment, the results of DAT for anti-IgG and anti-C3d were both positive, while anti-B was not detected in plasma, but stronger anti-B (3 +) was detected in acid eluent. experiments confirmed that NIPA of SBT promoted the specific binding of maternal-derived IgG anti-B to B antigen on RBCs of the newborn, thereby inducing acute intravascular hemolysis.
Conclusion: The NIPA effect of SBT promoted the specific binding of mother-derived IgG anti-B in newborn's plasma to the newborn's RBC B antigens and formed an immune complex, and then activated complement, which led to acute intravascular hemolysis. Drugs such as SBT with NIPA effect should not be used for newborns with HDN.
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http://dx.doi.org/10.3389/fimmu.2021.698541 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Department of Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.
Oxf Med Case Reports
December 2024
Manchester Heart Centre, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, United Kingdom.
We report a case of non-ST elevation myocardial infarction in a 36-year-old man with Erdheim-Chester disease (ECD). Multimodality assessment revealed acute coronary thrombus with simultaneous recurrent pulmonary embolism in spite of compliance with a direct oral anticoagulant. Prior case reports of acute myocardial infarction in this population have not outlined the role of catheter based intravascular assessment and treatment in this rare clinical entity.
View Article and Find Full Text PDFJ Clin Neurosci
December 2024
Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan; Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Re-occlusion and intravascular thrombus formation following mechanical thrombectomy (MT) in stroke patients worsen clinical outcomes. Although early administration of antiplatelet therapy (APT) prevents these complications, current guidelines advise against using APT soon after intravenous thrombolysis (IVT), making the management of atherothrombotic large vessel occlusion (AT-LVO) difficult. We investigated the safety of early APT for acute AT-LVO treated with MT following IVT.
View Article and Find Full Text PDFJ Vasc Access
December 2024
Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
The fibroblastic sleeve is a structure potentially enveloping any intravascular device. At ultrasound scan, it typically presents as a thin layer of variably echogenic material covering the catheter surface, which usually tends to remain into the vessel after the catheter removal. However, several case reports have documented its migration toward the heart or pulmonary artery after a central venous catheter removal.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
December 2024
Department of (Interventional) Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
Background: Intravascular ultrasound (IVUS)-guided optimization of suboptimal fractional flow reserve (FFR) following percutaneous coronary intervention (PCI) results in a significant increase in both post-PCI FFR and minimal lumen and stent areas (MLA and MSA, respectively). However, the impact of clinical presentation with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) versus chronic coronary syndrome (CCS) on the efficacy of PCI optimization remains unknown.
Methods: This was a prespecified subgroup analysis of the FFR REACT trial comparing IVUS-guided PCI optimization versus no further treatment in 291 patients with a post-PCI FFR < 0.
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