Thalassemia intermedia (TI) patients may need a transfusion during physiological stress conditions, such as pregnancy. We present a case of a female TI patient with emerging transfusion-refractory anaemia during pregnancy, which resolved after splenectomy performed simultaneously with cesarean delivery. A 26-year pregnant woman at 29th gestational weeks was referred with a diagnosis of TI due to emerging anaemia which was refractory to transfusion. Splenectomy at term was decided to improve anaemia, and transfusion response. A preterm infant was delivered by cesarean section due to threatened preterm labour. Once the uterine incision was closed, an open splenectomy was performed. Postoperative follow-up was uneventful. To the best of our knowledge, the present case is the first open splenectomy performed during cesarean delivery as a salvage option for the management of transfusion-refractory anaemia. Key Words: Thalassemia intermedia, Splenectomy, Pregnancy, Hemolytic anaemia.
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http://dx.doi.org/10.29271/jcpsp.2022.10.1344 | DOI Listing |
Tohoku J Exp Med
January 2023
Division of Hematology and Rheumatology, Tohoku Medical and Pharmaceutical University Hospital.
Lenalidomide (LEN), one of the key drugs in the treatment of myelodysplastic syndromes (MDS) with 5q deletion, as well as multiple myeloma (MM), has various immunomodulatory effects and has been associated with autoimmune diseases, including immune thrombocytopenic purpura (ITP). A 78-year-old man presented with pancytopenia and was diagnosed with MDS with 5q deletion and other chromosomal abnormalities. Two cycles of LEN therapy (one cycle: 10 mg/day for 21 days) resulted in a transient improvement in anemia, followed by MDS progression with severe thrombocytopenia (4 × 10/L) refractory to platelet transfusions.
View Article and Find Full Text PDFJ Coll Physicians Surg Pak
October 2022
Department of Internal Medicine, Faculty of Medicine, Division of Hematology, Istanbul University, Istanbul, Turkey.
Thalassemia intermedia (TI) patients may need a transfusion during physiological stress conditions, such as pregnancy. We present a case of a female TI patient with emerging transfusion-refractory anaemia during pregnancy, which resolved after splenectomy performed simultaneously with cesarean delivery. A 26-year pregnant woman at 29th gestational weeks was referred with a diagnosis of TI due to emerging anaemia which was refractory to transfusion.
View Article and Find Full Text PDFCureus
December 2020
Internal Medicine, Emory University School of Medicine, Atlanta, USA.
A 33-year-old previously healthy Middle Eastern male presented to the emergency department with four weeks of progressively worsening fatigue, dyspnea on exertion, night sweats, and a 10-pound weight loss after suffering a self-limiting viral upper respiratory illness. He was found to be profoundly anemic and thrombocytopenic with normal white blood cell count with a lymphocytic predominance. His anemia was refractory to red blood cell transfusions, to which he developed hyperbilirubinemia.
View Article and Find Full Text PDFCureus
September 2020
Gastroenterology, All India Institute of Medical Sciences, Patna, IND.
Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of chronic liver disease associated with organ failures. Anemia of diverse etiology is common in patients with ACLF. Spur cell anemia (SCA) is a form of acquired hemolytic anemia that occurs rarely in such patients due to dysregulated lipids metabolism.
View Article and Find Full Text PDFProc (Bayl Univ Med Cent)
July 2020
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
A 69-year-old man with irritable bowel syndrome on a restricted diet presented with fatigue, myalgias, extensive bilateral lower-extremity petechiae and ecchymoses, transfusion-refractory anemia, and elevated inflammatory markers. A low serum vitamin C level led to the diagnosis of scurvy. This is the first reported case of vitamin C deficiency and clinical scurvy related to voluntary dietary restriction from irritable bowel syndrome in an adult patient.
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