Hematology Commons^™

Spur Cell Anemia: A Crucial Unanticipated Anemia In Critical Care, Jobe Ashby

Books, Presentations, Posters, Etc.

INTRODUCTION: Spur Cell Anemia (SCA) is a rare underrecognized non-autoimmune hemolytic anemia occurring in severe liver disease with prognostic implications. Since the 1980s there have been only a few dozen case reports and clinical images concerning SCA. We present a case of a young man managed in the ICU with multiorgan failure and a masked diagnosis of SCA. DESCRIPTION: A 33-year-old man was found down and presented to the ICU with hematemesis and hemorrhagic shock. He required massive transfusion for bleeding esophageal varices that were later banded and an expanding thigh hematoma. He was diagnosed with alcohol induced liver cirrhosis …

Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran

HCA Healthcare Journal of Medicine

Background

We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.

Case Presentation

A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …

Novel Rpl30 Variant In Diamond Blackfan Anemia Demonstrates Early Impact On Erythroid Differentiation With Downregulated Gata1-Hsp70, Alexandra Prosser-Dombrowski, Irina Pushel, Jacqelyn Nemechek, Priyanka Kumar, Jay L. Vivian, Jennifer Gerton, John M. Perry

Research Days

Background: Diamond Blackfan anemia (DBA) is an inherited bone marrow failure syndrome caused by ribosomal protein gene mutations leading to apoptosis of erythroid progenitors. We identified a novel heterozygous variant (c.167+769C>T) in the noncoding region of RPL30 in a patient diagnosed with DBA.

Objectives/Goal: We hypothesized that this variant stunts erythroid differentiation at the proerythroblast stage and is pathogenic for DBA.

Methods/Design: We developed an induced pluripotent stem cell (iPSC) model with a wild type (WT) and three CRISPR-Cas9 edited RPL30 mutant clones. iPSCs were differentiated into hematopoietic stem cells, which were assessed by flow cytometry and single cell …

Effect Of Social Determinants Of Health On Clinic Visit Attendance In Patients With Hemophilia, Shailly Gaur Md, Brian Lee Phd, Mph, James Anderst Md, Msci, Katie Foote Lscsw, Lcsw, Osw-C, Andrea Bradley-Ewing Mpa, Ma, Shannon Carpenter Md

Research Days

Background

Social determinants of health (SDOH) create barriers to seeking care regularly, especially for patients with chronic disease. Patients with moderate-severe hemophilia A and B (factor 8 and 9 deficiencies respectively) have a life-long higher risk of bleeding and require chronic therapies. Specialized care is offered through hemophilia treatment centers (HTCs); however, these can be difficult to access for some individuals. Previous SDOH research in this patient population has been limited; therefore, it can be difficult to identify the barriers to care that exist. There is a need to examine SDOH more thoroughly to create patient-directed interventions to improve access …

Tattoos As A Risk Factor For Malignant Lymphoma, Michael Escobar, Hajirah Farah, Anna Zhao, Hafsah Umerani, Rubab Imtiaz

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Nielsen C, Jerkeman M, Jöud AS. Tattoos as a risk factor for malignant lymphoma: a population-based case-control study. EClinicalMedicine. 2024;72:102649. Published 2024 May 21. https://doi.org/10.1016/j.eclinm.2024.102649

for a teenage patient contemplating getting a tattoo.

Atypical Dengue Fever With Severe Hematological Manifestations: A Case From The Rio Grande Valley, Elias Arellano Villanueva, Alhasan Asaad, Jose Campo Maldonado

Research Symposium

Background: Dengue fever, a mosquito-borne viral illness, is endemic in tropical regions, including border regions like the Rio Grande Valley while often self-limited, severe presentations such as dengue hemorrhagic fever and dengue shock syndrome highlight its challenges and complexities. This report describes an atypical dengue case with severe hematological manifestations, underscoring the diagnostic challenges and the importance of early recognition, multidisciplinary evaluation, and evidence-based management.

Case Presentation: A 22-year-old Hispanic female with no significant past medical history presented to the ED with hematemesis and fever following her travel to Monterrey, Mexico. Initial symptoms included high fever (107.6°F), chills, diarrhea, vomiting, …

Nosebleed No More: Recognizing And Diagnosing Factor Viii Inhibitor, Salam Harb, Leidy Huie Martinez Md, Jose Alvarado Md, Ajit Koli Do, Hazem Nasef Ms4

HCA-NSU MD Research Day

Acquired hemophilia is a condition characterized by the unexpected onset of severe bleeding due to an issue with coagulation factors. Typically, this disorder results from the production of autoantibodies against the Factor VIII coagulation factor. Although acquired hemophilia is an extremely rare condition, with an annual incidence of just 1.5 cases per million, it is crucial to recognize and understand it. This is because diagnosing this disorder is intricate, and if left undiagnosed and untreated, it can lead to high levels of morbidity and mortality. This case stands out as the condition typically targets older adults, with around 80% of …

The Utility Of Interventional Anesthesia, Kylie Daguio, Kiley Jackson, Samantha Boever, Andrew Chang, James Keane, Leonard B. Goldstein

SOMA Faculty Publications

no abstract

Chromatin Pattern Quantification For The Differentiation Of White Blood Cells, Paul Young, Ryan Cordner, Abigail Gordhamer

Annual Research Symposium

Nuclear chromatin patterns have been used historically to distinguish between different developmental stages and lineages of white blood cells. While it is common to characterize cells based on arbitrary ‘open’ or ‘closed’ chromatin patterns, quantification of chromatin data is lacking. By extracting nuclei from a database of white blood cells and running fractal analyses using TWOMBLI, we were able to produce meaningful data quantifying chromatin patterns. Our data were put through a random forest algorithm which grouped each point based on relationship probability. The algorithm compared immature and mature cell types as well as cells of similar maturity and differing …

Advancing Virtual At-Home Care For Community Health Center Patients Using Patient Self-Care Tools, Technology, And Education [Letter], Cheryl Modica, Joy H. Lewis, Curtis Bay

SOMA Faculty Publications

Abstract

Introduction

Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers.

Objective

This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven …

Myth Of The Pentad: Approaching Thrombotic Thrombocytopenic Purpura, Nidhi Patel, Md, Meera Jain, Md, Natasha Edwin, Md

Poster Presentations

No abstract provided.

Assessment Of Appropriate Anticoagulation And Rates Of Bte In Ambulatory Oncology Patients Using A Validated Risk Assessment Model (Khorana Scote), David Page, Alan Su, Nikki Moxon, Staci Mellinger, Tracy L. Kelly, Katherine Lyon, Pharmd, Ian Ingram, Stephanie Matta, Pharmd, Bcop

Books, Presentations, Posters, Etc.

Abstract: Cancer associated venous thromboembolisms (VTE) are associated with higher health care resource utilization (number of hospitalizations, hospital length of stay, inpatient/outpatient medical services) and can complicate treatment of cancer. The Khorana Predictive Model for Chemotherapy-Associated VTE is a validated risk assessment model that determines a patient’s risk of developing VTEs and provides recommendations for starting prophylactic anticoagulation in ambulatory oncology patients. The Khorana Score is composed of various patient characteristics including site of primary cancer, prechemotherapy platelet count, hemoglobin level, prechemotherapy leukocyte count, and BMI. National Comprehensive Cancer Network (NCCN) supportive care guidelines recommend prophylactically starting an anticoagulant if …

A Vexing Case: A Newly Discovered Autoinflammatory Disease, Ashley Edwards, Md, Caroline Mcculley, Md

Poster Presentations

Introduction: Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) Syndrome is a recently recognized adult-onset autoinflammatory disease that can lead to potentially lifethreatening multi-system inflammation with estimated prevalence of up to 1 in 5,000 males over the age of 50. Given its significant morbidity and mortality and high prevalence, increased awareness of this condition is of foremost importance. Herein we outline a case of VEXAS syndrome. Case Presentation: Mr. N is a 73-year-old male with a past medical history significant for hypertension and recent episode of uveitis who first presented to the hospital for significant unintentional weight loss, fevers, and abdominal …

Using Individual Collector Blood Culture Volume Data To Improve Fill Volume, Richard S. Kirby, Jenna M. Meloni, Karishma B. Naik, Matthew D. Minnear, Matthew A. Pettengill

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

The Immunomodulating Effects Of Morphine Dependence And Withdrawal In A Rat Model, Mark Stoll

Annual Research Symposium

Would you like to know what happens to the immune system during opioid drug withdrawal?

A Clot To Worry About: Venous Thromboembolism In Severe Ulcerative Colitis, Jin Yun, Do, Donald Lum, Md

Poster Presentations

No abstract provided.

The Utility Of Fungal Blood Cultures: A Quality Improvement Study, Brigette Schuman, Elizabeth Savage, Vanessa Hoytfox

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

A Simple Critical Care Provider Transfusion Education Program Reduces Blood Product Use, Ivan Martinez Avalos, Stephen Malkoski, Mellody Descoteaux

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

Eagle Syndrome: Efficacies Of Medical And Surgical Treatments, Kirklin Mitchell

Capstone Showcase

Eagle Syndrome is a rare syndrome caused by elongation of the styloid process of the temporal bone or calcification of the stylohyoid ligament occurring in a very small percentage of the population that can cause a wide range of common symptoms, leading to it being often misdiagnosed. While there are no set standards for treating Eagle Syndrome, both pharmaceutical and surgical options exist. Pharmaceutical options are often ineffective in long term treatment so surgery is usually required for full symptom resolution. Transoral and Transcervical surgeries have similar efficacies but each come with important drawbacks when considering which type of surgery …

Transient Leukopenia, Thrombocytopenia, And Severe Neutropenia Associated With Acute Sars-Cov-2 Infection, Austin Schatzman, Julia Vandenheuvel Md, Tibisay Villalobos Md, Kris Rooney Md

Department of Pediatrics

No abstract provided.

A Study Examining The Safety And Efficacy Of Ferric Carboxymaltose In A Large Pediatric Cohort, Chandni Dargan Md, David Simon Do

Research Days

Background: Iron deficiency anemia (IDA) is common in the pediatric population with varying high-risk factors. Intravenous (IV) iron supplementation has become more desirable in patients with moderate to severe anemia and in patients who are either unresponsive to or have adverse side-effects secondary to oral iron. Iron sucrose and Iron dextran have been traditionally used in pediatrics while ferric carboxymaltose (FCM) has only been FDA approved in adults. One of the major advantages of FCM is the ease of dosing and efficacy. Though FCM was approved for adults in 2013 and there have been no safety concerns, it is not …

A New Paradigm: Ecmo Therapy In Pediatric Hematology/Oncology Patients, Igor Areinamo

Research Days

Background: The use of extracorporeal membrane oxygenation (ECMO) for support of pediatric patients has significantly increased in the past years. Patients with known oncologic diseases, immunodeficiencies, or bone marrow transplants (BMT) have traditionally not been considered candidates for Extracorporeal membrane oxygenation (ECMO) due to perceived high risk for mortality. Ongoing advances have continued to push the boundaries of ECMO use and we report our recent experience with this patient population

Objectives/Goal: To evaluate survival to discharge of pediatric patients who require ECMO support and who also have an underlying hematologic or oncologic disease process. To determine specific patient characteristics that …

Hydroxyurea Lowers The Frequency Of Sickle Cell Vaso-Occlusive Crises, Corey S. Macrander

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Charache S, Terrin ML, Moore RD, et al. Effect of hydroxyurea on the frequency of painful crises in sickle cell anemia. N Engl J Med 1995;(332):1317-1322 doi: 10.1056/nejm199505183322001

Low Molecular-Weight Heparin Is Better Than Warfarin For Prevention Of Recurrent Venous Thromboembolism In Cancer Patients, Sarah Choi

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lee AYY, Levin MN, Bake RI, et al. Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med. 2003;349:146-153. doi: 10.1056/NEJMoa025313

Your Guide To Immunotherapy, Lehigh Valley Health Network, Accc Association Of Community Cancer Centers

Lehigh Valley Topper Cancer Institute

No abstract provided.

C-Anca Positive Necrotizing Crescentic Glomerulonephritis With Linear Immunoglobulin Staining, Akshita Mehta

GW Research Days 2015

Necrotizing crescentic glomerulonephritis is found in anti-glomerular basement membrane (GBM) disease (Type 1), immune complex (Type 2) deposition and anti-neutrophil cytoplasmic (ANCA)-related disease (Type 3).

ANCA positive glomerulonephritis is typically characterized on renal biopsy as pauci-immune, with mild or absent glomerular staining for immunoglobulin, or complement staining by immunofluorescence.

Rare cases of concomitant p-ANCA plus linear immunofluorescence pattern staining have been discussed, however none with prior association with c-ANCA.

We report a case of systemic c-ANCA pulmonary-renal syndrome with anti-GBM-disease-typical linear staining on renal biopsy immunofluorescence.

The Nurse's Knowledge Of Blood Conservation As A Part Of Blood Management, Lindsey Putnam Austin

Nursing Theses and Capstone Projects

Medicine has historically regarded blood transfusion as an integral component of major surgery or illness. However, clinical studies have shown that allogeneic blood transfusions are associated with increased morbidity and decreased survival. Knowledge of this research and the concepts of blood conservation so as to avoid unnecessary blood transfusions is needed in order to deliver holistic care and serve as patient advocate. This knowledge reaches every specialty of nursing care.

This study of the nurse's knowledge of blood conservation as a part of blood management utilizes The Conservation Model developed by Myra E. Levine in 1973. Levine's work is a …