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[PMID]: 28470926 [Au] Autor: Lehle K; Lubnow M; Philipp A; Foltan M; Zeman F; Zausig Y; Lunz D; Schmid C; Müller T [Ad] Endereço: Department of Cardiothoracic Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042, Regensburg, Germany. [Ti] Título: Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival? [So] Source: Eur J Heart Fail;19 Suppl 2:110-116, 2017 May. [Is] ISSN: 1879-0844 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: AIMS: Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome. METHODS AND RESULTS: This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60). Lactate, arterial pH value and fHb were measured daily before (pre-fHb) and during ECLS. CPR caused a pronounced increase in pre-fHb (group1, 318 (138/586) mg/L; group2, 212 (107/439) mg/L; group3, 79 (53/232) mg/L; p < 0.001). Within 24 hours on ECLS, fHb declined significantly. Compared to group 3 without CPR, group1 and 2 had a lower pH value (group1, 7.10 (6.93/7.20); group2, 7.21 (7.16/7.27); group3, 7.28 (7.20/7.35); p < 0.001), and an increased lactate level (group1, 88 (55/129) mg/dL; group2, 76 (36/111) mg/dL; group3, 52 (25/83) mg/dL; p < 0.0001). Multivariante analysis showed that pre-fHb had no prognostic value for survival. Only a low pre-lactate was a surrogate marker for successful weaning (p < 0.0001) and discharge from hospital (p = 0.0028). CONCLUSIONS: CPR was associated with a strongly increased fHb irrespective of ECLS. Implantation of ECLS did not aggravate hemolysis but instead decreased it within 24 hours. In this study low pre-fHb had no predictive value for survival. [Mh] Termos MeSH primário: Acidose/epidemiologia Anemia Hemolítica/epidemiologia Oxigenação por Membrana Extracorpórea/efeitos adversos Insuficiência Cardíaca/terapia Hemólise [Mh] Termos MeSH secundário: Acidose/sangue Acidose/etiologia Idoso Anemia Hemolítica/sangue Anemia Hemolítica/etiologia Feminino Alemanha/epidemiologia Hemoglobinas/metabolismo Seres Humanos Masculino Meia-Idade Prevalência Prognóstico Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Hemoglobins) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE [do] DOI: 10.1002/ejhf.854

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[PMID]: 29381966 [Au] Autor: Liu MX; Wen XY; Leung YK; Zheng YJ; Jin MS; Jin QL; Niu JQ [Ad] Endereço: Department of Hepatology, The First Hospital of Jilin University. [Ti] Título: Hemolytic anemia in alcoholic liver disease: Zieve syndrome: A case report and literature review. [So] Source: Medicine (Baltimore);96(47):e8742, 2017 Nov. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Zieve syndrome, a rarely reported disease resulting from alcohol abuse, consists of a triad of symptoms: hemolytic anemia, cholestatic jaundice, and transient hyperlipidemia. It is largely under-recognized and under-reported, possibly because of unawareness of the condition by physicians. Here, we report a case of Zieve syndrome managed at the Jilin University First Bethune Hospital. PATIENT CONCERNS: A 30-year-old Chinese woman presented with a 4-month history of fatigue, yellowish discoloration of the eyes, and tea-colored urine. She had been a heavy drinker for 2 years prior to onset of the disease with an average daily alcohol intake of 60 g/d and more than 80 g/d for the previous 6 months. DIAGNOSIS: The diagnosis of Zieve syndrome was confirmed based on hemolysis and cholestatic jaundice secondary to alcoholic liver disease and heavy drinking. Bone marrow biopsy and liver biopsy both supported the diagnosis. INTERVENTIONS: We treated her with abstinence from alcohol and supportive therapy. OUTCOMES: The patient was discharged 14 days after admission with an improvement in symptoms, which continued to subside during the 2-month follow-up period. LESSONS: Doctors confronted with hemolysis in a patient with alcoholic liver disease should be aware of the under-reported Zieve syndrome. Recognition of this syndrome could help doctors avoid unnecessary invasive procedures and emphasize the importance of alcohol abstinence as the mainstay of management. Glucocorticoids may not be useful in treating hemolytic anemia in Zieve syndrome. [Mh] Termos MeSH primário: Anemia Hemolítica/complicações Hepatopatias Alcoólicas/complicações [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Hiperlipidemias/etiologia Icterícia/etiologia Síndrome [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180220 [Lr] Data última revisão: 180220 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008742

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[PMID]: 29281575 [Au] Autor: Sykes DB; Rosovsky RP; Singhal AB; Gonzalez RG; Moy AP [Ad] Endereço: From the Departments of Medicine (D.B.S., R.P.R.), Neurology (A.B.S.), Radiology (R.G.G.), and Pathology (A.P.M.), Massachusetts General Hospital, and the Departments of Medicine (D.B.S., R.P.R.), Neurology (A.B.S.), Radiology (R.G.G.), and Pathology (A.P.M.), Harvard Medical School - both in Boston [Ti] Título: Case 40-2017. A 32-Year-Old Woman with Headache, Abdominal Pain, Anemia, and Thrombocytopenia. [So] Source: N Engl J Med;377(26):2581-2590, 2017 12 28. [Is] ISSN: 1533-4406 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Cefaleia/etiologia Hemoglobinúria Paroxística/diagnóstico Trombose Venosa/etiologia [Mh] Termos MeSH secundário: Dor Abdominal/etiologia Adulto Anemia/etiologia Anemia Hemolítica/diagnóstico Anticorpos Monoclonais Humanizados/efeitos adversos Anticorpos Monoclonais Humanizados/uso terapêutico Exame de Medula Óssea Encéfalo/diagnóstico por imagem Veias Cerebrais/diagnóstico por imagem Coagulação Intravascular Disseminada/diagnóstico Feminino Hemoglobinúria Paroxística/complicações Hemoglobinúria Paroxística/tratamento farmacológico Seres Humanos Radiografia Abdominal Baço/diagnóstico por imagem Baço/patologia Trombocitopenia/etiologia Tomografia Computadorizada por Raios X Trombose Venosa/diagnóstico por imagem Transtornos da Visão/etiologia [Pt] Tipo de publicação: CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antibodies, Monoclonal, Humanized); A3ULP0F556 (eculizumab) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180115 [Lr] Data última revisão: 180115 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1056/NEJMcpc1710566

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[PMID]: 29174474 [Au] Autor: Fibach E; Rachmilewitz EA [Ad] Endereço: Hadassah-Hebrew University Medical Center, Department of hematology, Jerusalem, Israel. Electronic address: Fibach@yahoo.com. [Ti] Título: Iron overload in hematological disorders. [So] Source: Presse Med;46(12 Pt 2):e296-e305, 2017 Dec. [Is] ISSN: 2213-0276 [Cp] País de publicação: France [La] Idioma: eng [Ab] Resumo: While most common symptom of impairment of iron homeostasis is iron deficiency anemia, some hematological disorders are associated with iron overload (IO). These disorders are related mainly to chronic severe hemolytic anemia, where red blood cells (RBC) or their precursors are destroyed prematurely (hemolyzed), leading to anemia that cannot be compensated by increased production of new RBC. In such cases, IO is mainly due to repeated RBC transfusions and/or increased uptake of iron in the gastrointestinal tract. Normally, iron is present in the plasma and in the cells bound to compounds that render it redox inactive. Iron overload leaves a fraction of the iron free (labile iron pool) and redox active, leading to the generation of excess free radicals such as the reactive oxygen species. This condition upsets the cellular redox balance between oxidants and antioxidants, leading to oxidative stress. The free radicals bind to various cellular components, thereby becoming toxic to vital organs. Oxidative stress may also affect blood cells, such as RBC, platelets and neutrophils, exacerbating the anemia, and causing recurrent infections and thrombotic events, respectively. The toxic effect of IO can be decreased by treating the patients with iron chelators that enter cells, bind free iron and remove it from the body through the urine and feces. Iron toxicity may be also ameliorated by treatment with anti-oxidants that scavenge free radicals and/or correct their damage. The use of iron chelators is widely accepted when started in young patients with severe chronic anemia, but is still debatable as a therapeutic modality for older patients suffering from IO due to myelodysplastic syndromes. It should be noted that in addition to preventing iron toxicity, some compounds with iron chelator activity may also benefit other aspects of hematological disorders. These aspects include stimulation of platelet production, inhibition of leukemic cell proliferation and induction of their differentiation. Compounds with such multiple activities may prove beneficial for at least some patients with leukemia and myelodysplastic syndromes. [Mh] Termos MeSH primário: Doenças Hematológicas/complicações Sobrecarga de Ferro/etiologia [Mh] Termos MeSH secundário: Anemia Hemolítica/complicações Doenças Hematológicas/metabolismo Seres Humanos Sobrecarga de Ferro/terapia Estresse Oxidativo [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171227 [Lr] Data última revisão: 171227 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171128 [St] Status: MEDLINE

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[PMID]: 29231762 [Au] Autor: Balaet C; Coculescu BI; Balaet M; Manole G; Dinca GV [Ad] Endereço: a Faculty of General Nursing , Bioterra University , Bucharest , Romania. [Ti] Título: Haemolytic anaemia and hepatocitolysis associated with hypermagnesaemia by repeated exposures to copper-calcium fungicides. [So] Source: J Enzyme Inhib Med Chem;33(1):184-189, 2018 Dec. [Is] ISSN: 1475-6374 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: For the medical practice, our manuscript acts as a signal, despite only presenting three cases which feature the association between hepatocytolysis, haemolysis and hypermagnesaemia. This clinical-biologic triad was highlighted with the workers who through the nature of their profession were exposing themselves periodically to vapours which contained copper sulphate neutralised with calcium hydroxide, a fungicide used for fruit trees. We are exclusively assessing the haematological perturbation. In this aetiological context, the generating mechanism for haemolysis is very probable biochemical, where hypercupraemia interferes with cellular antioxidant defence mechanisms. Hypothetically, the role of the redox homeostasis disorder in the intravascular destruction of erythrocytes is sustained, and particularly the coexistence of cell cytolysis in the medullary erythroid compartment, which can be assimilated with a possible ineffective erythropoiesis. [Mh] Termos MeSH primário: Anemia Hemolítica/induzido quimicamente Hidróxido de Cálcio/efeitos adversos Sulfato de Cobre/efeitos adversos Fungicidas Industriais/efeitos adversos Hipocalcemia/induzido quimicamente Fígado/efeitos dos fármacos [Mh] Termos MeSH secundário: Adulto Anemia Hemolítica/complicações Hidróxido de Cálcio/administração & dosagem Hidróxido de Cálcio/química Sulfato de Cobre/administração & dosagem Sulfato de Cobre/química Eritropoese/efeitos dos fármacos Fungicidas Industriais/administração & dosagem Fungicidas Industriais/química Seres Humanos Hipocalcemia/complicações Fígado/metabolismo Masculino Meia-Idade [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Fungicides, Industrial); LRX7AJ16DT (Copper Sulfate); PF5DZW74VN (Calcium Hydroxide) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171221 [Lr] Data última revisão: 171221 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171213 [St] Status: MEDLINE [do] DOI: 10.1080/14756366.2017.1409745

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[PMID]: 28818049 [Au] Autor: Fanello C; Onyamboko M; Lee SJ; Woodrow C; Setaphan S; Chotivanich K; Buffet P; Jauréguiberry S; Rockett K; Stepniewska K; Day NPJ; White NJ; Dondorp AM [Ad] Endereço: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. caterina@tropmedres.ac. [Ti] Título: Post-treatment haemolysis in African children with hyperparasitaemic falciparum malaria; a randomized comparison of artesunate and quinine. [So] Source: BMC Infect Dis;17(1):575, 2017 Aug 17. [Is] ISSN: 1471-2334 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Parenteral artesunate is the treatment of choice for severe malaria. Recently, haemolytic anaemia occurring 1 to 3 weeks after artesunate treatment of falciparum malaria has been reported in returning travellers in temperate countries. METHODS: To assess these potential safety concerns in African children, in whom most deaths from malaria occur, an open-labelled, randomized controlled trial was conducted in Kinshasa, Democratic Republic of Congo. 217 children aged between 6 months and 14 years with acute uncomplicated falciparum malaria and parasite densities over 100,000/µL were randomly allocated to intravenous artesunate or quinine, hospitalized for 3 days and then followed for 42 days. RESULTS: The immediate reduction in haemoglobin was less with artesunate than with quinine: median (IQR) fall at 72 h 1.4 g/dL (0.90-1.95) vs. 1.7 g/dL (1.10-2.40) (p = 0.009). This was explained by greater pitting then recirculation of once infected erythrocytes. Only 5% of patients (in both groups) had a ≥ 10% reduction in haemoglobin after day 7 (p = 0.1). One artesunate treated patient with suspected concomitant sepsis had a protracted clinical course and required a blood transfusion on day 14. CONCLUSIONS: Clinically significant delayed haemolysis following parenteral artesunate is uncommon in African children hospitalised with acute falciparum malaria and high parasitaemias. TRIAL REGISTRATION: ClinicalTrials.gov ; Identifier: NCT02092766 (18/03/2014). [Mh] Termos MeSH primário: Anemia Hemolítica/induzido quimicamente Antimaláricos/efeitos adversos Artemisininas/efeitos adversos Malária Falciparum/tratamento farmacológico Quinina/efeitos adversos [Mh] Termos MeSH secundário: Administração Intravenosa Adolescente Antimaláricos/uso terapêutico Artemisininas/administração & dosagem Artemisininas/uso terapêutico Transfusão de Sangue Criança Pré-Escolar República Democrática do Congo Eritrócitos/efeitos dos fármacos Eritrócitos/parasitologia Feminino Hemólise/efeitos dos fármacos Hospitalização Seres Humanos Lactente Masculino Quinina/administração & dosagem Quinina/uso terapêutico Sepse/parasitologia Sepse/terapia [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Antimalarials); 0 (Artemisinins); 60W3249T9M (artesunate); A7V27PHC7A (Quinine) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171106 [Lr] Data última revisão: 171106 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170819 [St] Status: MEDLINE [do] DOI: 10.1186/s12879-017-2678-0

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[PMID]: 28780041 [Au] Autor: Page EE; Little DJ; Vesely SK; George JN [Ad] Endereço: Department of Biostatistics and Epidemiology, College of Public Health, Oklahoma City, OK; Hematology-Oncology Section, Department of Medicine, College of Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK. [Ti] Título: Quinine-Induced Thrombotic Microangiopathy: A Report of 19 Patients. [So] Source: Am J Kidney Dis;70(5):686-695, 2017 Nov. [Is] ISSN: 1523-6838 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Quinine can cause diverse and severe immune-mediated adverse reactions, including thrombotic microangiopathy (TMA). Our objective was to describe the presenting features and long-term outcomes of patients with quinine-induced TMA. STUDY DESIGN: A case series of 19 patients with quinine-induced TMA treated with plasma exchange. SETTING & PARTICIPANTS: Patients with quinine-induced TMA initially suspected of having thrombotic thrombocytopenic purpura (TTP) were identified among patients enrolled in the Oklahoma TTP-Hemolytic Uremic Syndrome Registry. OUTCOMES: The clinical course of the initial episode and morbidity and mortality following recovery. MEASUREMENTS: The diagnosis of quinine-induced TMA was confirmed by documentation of quinine-dependent antibodies reactive with platelets or neutrophils and/or by previous quinine-associated systemic symptoms. Clinical data from the initial episode and long-term follow-up were described, focusing on kidney function. RESULTS: 19 of the 509 patients enrolled in the registry in 1989 to 2015 had quinine-induced TMA. 18 patients had quinine-dependent antibodies reactive with platelets and/or neutrophils (1 patient died before testing); 8 patients had a history of quinine-associated systemic symptoms. All patients were white; 18 were women. Quinine exposure was in pill form for 18 patients and as tonic water for 1. All patients had microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. All were initially misdiagnosed as having TTP or hemolytic uremic syndrome, and adverse reactions to quinine were not initially suspected. 1 patient died before treatment began; 17 of the 18 surviving patients required dialysis. 14 patients developed chronic kidney disease, 3 of whom developed end-stage renal disease. 8 patients died. LIMITATIONS: Patients for whom plasma exchange was not requested were not identified. CONCLUSIONS: Quinine-induced TMA causes severe acute kidney injury that commonly results in chronic kidney disease. [Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente Anemia Hemolítica/induzido quimicamente Relaxantes Musculares Centrais/efeitos adversos Quinina/efeitos adversos Sistema de Registros Trombocitopenia/induzido quimicamente Microangiopatias Trombóticas/induzido quimicamente [Mh] Termos MeSH secundário: Lesão Renal Aguda/terapia Adulto Idoso Anemia Hemolítica/terapia Feminino Seres Humanos Masculino Meia-Idade Oklahoma Troca Plasmática Diálise Renal Trombocitopenia/terapia Microangiopatias Trombóticas/terapia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Muscle Relaxants, Central); A7V27PHC7A (Quinine) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170807 [St] Status: MEDLINE

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[PMID]: 28737602 [Au] Autor: Aledort LM; Singleton TC; Ulsh PJ [Ad] Endereço: *Department of Hematology and Medical Oncology, Icahn School of Medicine, New York, NY †Department of Pediatric Hematology/Oncology, Tulane University, New Orleans, LA ‡Kedrion Biopharma, Fort Lee, NJ. [Ti] Título: Treatment of Congenital Thrombotic Thrombocytopenia Purpura: A New Paradigm. [So] Source: J Pediatr Hematol Oncol;39(7):524-527, 2017 Oct. [Is] ISSN: 1536-3678 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Congenital thrombotic thrombocytopenia purpura (cTTP) is a very rare disorder worldwide. Standard treatment of recognized cases has been to administer fresh frozen plasma as the source of ADAMTS13, to replenish the absent ADAMTS13 enzyme. An alternative source, a plasma-derived factor VIII concentrate used for hemophilia A, and found to contain this enzyme, was reported to be effective in 1 patient in the United States. We now report details on a US cohort of 8 cTTP patients who have been successfully treated for varying periods with a marketed antihemophilic factor concentrate Koate-DVI. This biological product has been used successfully on demand in varying doses to treat acute exacerbations, as well as prophylactically (3 to 6 U ADAMTS13 every 3 to 21 d). Self-infused at home, in lieu of fresh frozen plasma therapy in the hospital setting, this product has effectively prevented episodes of thrombocytopenia, microangiopathic hemolytic anemia, and the concomitant organ damage in these patients. This specific virus inactivated product can be used to prevent further manifestations of this congenital enzyme deficiency. [Mh] Termos MeSH primário: Proteína ADAMTS13/administração & dosagem Púrpura Trombocitopênica Trombótica/tratamento farmacológico [Mh] Termos MeSH secundário: Proteína ADAMTS13/deficiência Adolescente Adulto Anemia Hemolítica/prevenção & controle Criança Estudos de Coortes Fator VIII/administração & dosagem Fator VIII/química Seres Humanos Trombocitopenia/prevenção & controle Estados Unidos Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (F8 protein, human); 9001-27-8 (Factor VIII); EC 3.4.24.87 (ADAMTS13 Protein); EC 3.4.24.87 (ADAMTS13 protein, human) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171025 [Lr] Data última revisão: 171025 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170725 [St] Status: MEDLINE [do] DOI: 10.1097/MPH.0000000000000917

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[PMID]: 28723780 [Au] Autor: Liu Z; Wang S; Qi W; Wang X; Sun D; Wang H; Zhang Y; Li Z; Zhu L; Zhao P; Guo H; Zhou C; Wang J [Ad] Endereço: aDepartment of Digestive of China-Japan Union Hospital affiliated to Jilin University bDepartment of Urology of First Hospital affiliated to Jilin University, Changchun cDepartment of Digestive of the Second Hospital of Daqing dDepartment of Digestive of the People's Hospital of Jilin City eDepartment of Digestive of the People's Hospital of Hunchun City, Jilin fDepartment of Infectious Diseases of the Fourth Hospital of Harbin Medical University, Heilongjiang, China. [Ti] Título: The relationship between ITPA rs1127354 polymorphisms and efficacy of antiviral treatment in Northeast Chinese CHC patients. [So] Source: Medicine (Baltimore);96(29):e7554, 2017 Jul. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: This prospective study investigated the relationship between 2 inosine triphosphatase (ITPA) polymorphisms (rs7270101 and rs1127354) and the efficacy of ribavirin-based antiviral therapy in hepatitis C virus (HCV)-infected Chinese patients.A total of 906 patients diagnosed with chronic hepatitis C receiving pegylated interferon (PEG-IFN) plus ribavirin combination therapy between January 2011 and January 2014 from 5 hepatitis centers in Northeast China were enrolled. The patients were divided into genotype 1 and non-genotype 1 groups according to the genotype of infected HCV. ITPA single nucleotide polymorphism (SNP) genotyping was performed for all patients. Ribavirin-induced hemolytic anemia and virological response (VR) were monitored during treatment and follow-up. Multivariate regression analysis was used to analyze the predictors for sustained virological response (SVR).IPTA rs7270101 variants were not detected. IPTA rs1127354 variants were detected and showed no difference between the genotype 1 and non-genotype 1 groups. IPTA rs1127354 genotype CC was related to a higher incidence of ribavirin-induced hemolytic anemia. For patients who received >80% of the planned ribavirin dose, rs1127354 variants and related ITPase were related to better SVR. Multivariate analysis showed that IPTA rs1127354 non-genotype CC, HCV genotype, a baseline HCV RNA level <4 × 10 IU/mL, IL-28B rs12979860 genotype CC, and low liver fibrosis were independent predictors for SVR during the combination therapy.IPTA rs1127354 variants and related ITPase were not only related with ribavirin-induced hemolytic anemia but also directly affected the SVR to PEG-IFN plus ribavirin combination therapy in Chinese HCV-infected patients. [Mh] Termos MeSH primário: Antivirais/uso terapêutico Hepatite C Crônica/tratamento farmacológico Hepatite C Crônica/genética Polimorfismo de Nucleotídeo Único Pirofosfatases/genética Ribavirina/uso terapêutico [Mh] Termos MeSH secundário: Anemia Hemolítica/induzido quimicamente Anemia Hemolítica/genética Antivirais/administração & dosagem Antivirais/efeitos adversos China Relação Dose-Resposta a Droga Quimioterapia Combinada Feminino Técnicas de Genotipagem Seres Humanos Interferon-alfa/administração & dosagem Interferon-alfa/efeitos adversos Interferon-alfa/uso terapêutico Masculino Meia-Idade Análise Multivariada Testes Farmacogenômicos Polietilenoglicóis/administração & dosagem Polietilenoglicóis/efeitos adversos Polietilenoglicóis/uso terapêutico Estudos Prospectivos Proteínas Recombinantes/administração & dosagem Proteínas Recombinantes/efeitos adversos Proteínas Recombinantes/uso terapêutico Ribavirina/administração & dosagem Ribavirina/efeitos adversos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY [Nm] Nome de substância: 0 (Antiviral Agents); 0 (Interferon-alpha); 0 (Recombinant Proteins); 30IQX730WE (Polyethylene Glycols); 49717AWG6K (Ribavirin); EC 3.6.1.- (Pyrophosphatases); EC 3.6.1.- (inosine triphosphatase); Q46947FE7K (peginterferon alfa-2a) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170808 [Lr] Data última revisão: 170808 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170721 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000007554

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[PMID]: 28703860 [Au] Autor: Bailén R; Kwon M; Pérez-Corral AM; Pascual C; Buño I; Balsalobre P; Serrano D; Gayoso J; Díez-Martín JL; Anguita J [Ad] Endereço: Hematology and Hemotherapy Department, Hospital General Universitario Gregorio Marañón. [Ti] Título: Transient hemolysis due to anti-D and anti-A produced by engrafted donor's lymphocytes after allogeneic unmanipulated haploidentical hematopoietic stem cell transplantation. [So] Source: Transfusion;57(10):2355-2358, 2017 Oct. [Is] ISSN: 1537-2995 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Development of de novo alloantibodies against recipient's red blood cell (RBC) antigens by engrafted donor's lymphocytes is a known phenomenon in the setting of allogeneic hematopoietic stem cell transplantation (HSCT). This situation is usually clinically insignificant. We report a case of early clinically relevant hemolytic anemia in a blood group A D+ patient, due to a limited production of anti-D and anti-A produced by nonpreviously sensitized newly engrafted donor's immune system. CASE REPORT: A 31-year-old Caucasian woman, blood group A , D+, with Hodgkin's lymphoma, received an unmanipulated haploidentical allogeneic peripheral blood HSCT after a nonmyeloablative conditioning regimen. Donor blood group was A B, D-. The patient had an uneventful course until Day +34, when she developed clinically significant hemolytic anemia with a positive direct antiglobulin test. Anti-D and anti-A produced by the donor-engrafted lymphocytes were detected both in serum and in eluate. The hemolysis produced an accelerated group change, turning the patient's ABO group into A B 2 weeks after the detection of the alloantibodies. As the residual patient's RBCs progressively disappeared, anti-D and anti-A production decreased and were not detected in serum by Day +41. CONCLUSION: This case illustrates that de novo alloantibody production against ABO and D antigens by the newly engrafted donor's lymphocytes can occasionally cause clinically significant anemia. To our knowledge, this is the first case reported of clinically significant hemolytic anemia due to a transient anti-D anti-A alloimmunization after T-cell-repleted haploidentical HSCT. [Mh] Termos MeSH primário: Anemia Hemolítica/etiologia Transplante de Células-Tronco Hematopoéticas/efeitos adversos Isoanticorpos/biossíntese Linfócitos/imunologia Imunoglobulina rho(D)/biossíntese [Mh] Termos MeSH secundário: Sistema do Grupo Sanguíneo ABO/imunologia Adulto Incompatibilidade de Grupos Sanguíneos Feminino Sobrevivência de Enxerto Seres Humanos Isoanticorpos/sangue [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (ABO Blood-Group System); 0 (Isoantibodies); 0 (RHO(D) antibody); 0 (Rho(D) Immune Globulin) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171023 [Lr] Data última revisão: 171023 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170714 [St] Status: MEDLINE [do] DOI: 10.1111/trf.14232

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