Abstract:
OBJECTIVE:To analyse the clinicopathological presentation, outcome and importance of bone marrow haemophagocytosis in patients with infection-associated haemophagocytic lymphohistiocytosis (IA-HLH) in a tertiary care hospital in Northern India. STUDY DESIGN:Between January 2007 and December 2009, 26 consecutive patients meeting the diagnostic criteria for IA-HLH, based on the HLH2004 protocol of the Histiocyte Society, were followed up for between 12 and 34 months (median 20 months). RESULTS:IA-HLH was diagnosed in three of the five patients who died 5-6 weeks after the onset of the illness, whereas diagnosis in the remaining group was made a median of 2 weeks after the onset of the illness. The predominant presenting features were fever (100%), hepatomegaly (69%), splenomegaly (58%) and anaemia (96%). All patients showed >3% haemophagocytosis on bone marrow studies-in four cases after serial aspiration/biopsies. Twenty-one (80.8%) cases were non-fatal and five (19.2%) patients died. The non-fatal cases included eight (38.1%) cases of viral infection, seven (33.3%) bacterial infections, two (9.6%) fungal and four (19.0%) protozoal infections; whereas four (80%) bacterial infections and one (20%) viral infection were associated with the fatal cases. The mean of the nadir blood counts of white blood cells, absolute neutrophil counts and platelets; the mean of all the peak biochemical parameters of liver function tests, lactate dehydrogenase and ferritin and the lowest fibrinogen values before treatment, differed significantly (p<0.05) between the non-fatal and the fatal group, being worse in the latter. CONCLUSIONS:IA-HLH is important because it can obscure the typical clinical features of the underlying primary disease, thus delaying the diagnosis and having a negative effect on the outcome. Although bone marrow haemophagocytosis is not a mandatory diagnostic criterion, we found it to be a useful tool together with biochemical parameters for early recognition of HLH, especially in developing countries lacking molecular and flow laboratories. The severity of pancytopenia and derangement in biochemical markers were significantly higher in the patients who died.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Nair V,Das S,Sharma A,Sharma S,Sharma P,Ray S,Bhattacharya Sdoi
10.1136/postgradmedj-2012-130955subject
Has Abstractpub_date
2013-04-01 00:00:00pages
185-92issue
1050eissn
0032-5473issn
1469-0756pii
postgradmedj-2012-130955journal_volume
89pub_type
杂志文章abstract::Long intergenic non-coding RNA 01296 (LINC01296) has been reported to play an important role in many human malignancies, but a consistent perspective has not been established now. To explore the prognostic value of LINC01296 in different types of human solid malignant tumours, we performed this meta-analysis.An electr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析,评审
doi:10.1136/postgradmedj-2019-136684
更新日期:2020-01-01 00:00:00
abstract::Muscarinic receptors are present on several different cells in lung and are predominantly involved in bronchoconstriction and mucus secretion. Muscarinic receptor activation leads to breakdown of phosphoinositides in airway smooth muscle cell membranes, which leads to intracellular calcium release and contraction. Mus...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1987-01-01 00:00:00
abstract::The introduction of spiral technology to computed tomography (CT) scanners in the late 1980s has revolutionised the field of CT. Spiral CT offers definite practical benefits over conventional scanners and has expanded the role of CT through the development of new scanning techniques. CT scanning now rivals magnetic re...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.868.96
更新日期:1998-02-01 00:00:00
abstract::The NHS 'Choose Wisely' campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the 'normal range'. It is often assum...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2018-135983
更新日期:2018-11-01 00:00:00
abstract::Venepuncture is commonly regarded as a trivial procedure allocated to the most junior medical staff. The result of this policy is that junior doctors are required to perform a minimally invasive procedure on consenting patients without any structured venepuncture training or assessment. Consequently, inexperienced doc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.843.23
更新日期:1996-01-01 00:00:00
abstract::The use of sulphasalazine in inflammatory bowel disease is often limited by intolerance or allergy. In previous studies 5-aminosalicylic acid (5ASA), the active ingredient of sulphasalazine, coated with an acrylic resin, has been shown to be as effective as sulphasalazine in maintaining remission. In this study coated...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.722.1047
更新日期:1985-12-01 00:00:00
abstract::Mild and self-limiting fever following bleomycin use is common, and a fatal hyperpyrexial response occurs rarely. In previously reported cases, such hyperpyrexia occurred either after the initial administration of the drug or during subsequent therapy following an initial pyrexial response. We describe a fatal hyperpy...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.764.417
更新日期:1989-06-01 00:00:00
abstract::Amlodipine is a dihydropyridine calcium antagonist with a unique pharmacokinetic profile providing advantages over other therapies of its kind. It has been shown to possess high oral absorption, long elimination half-life, smooth onset of action and long duration of pharmacodynamic activity. These properties result in...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1991-01-01 00:00:00
abstract::This study assesses the economic benefits of misoprostol in the prophylaxis of gastric ulcers larger than 0.3 cm in patients with osteoarthritis receiving non-steroidal anti-inflammatory drugs. Independent epidemiological data were obtained for patients in Scotland and the West Midlands. Co-diagnosis of arthritis with...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:10.1136/pgmj.66.778.639
更新日期:1990-08-01 00:00:00
abstract::The selective COX-2 inhibitors (coxibs) were originally developed to minimise the adverse effects of conventional non-steroidal anti-inflammatory drugs (NSAIDs) while maintaining the same analgesic and anti-inflammatory properties. Many large studies confirmed the improved gastric side effect profile of coxibs compare...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2005.042234
更新日期:2006-04-01 00:00:00
abstract::We report a case of adult pyloric obstruction caused by the delayed presentation of a congenital gastric diverticulum. The derivation, classification and treatment of these abnormalities are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.798.296
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:Epidemiological and family studies suggest that lung cancer results from the combined effects of age, smoking and genetic factors. Chronic obstructive pulmonary disease (COPD) is also an independent risk factor for lung cancer and coexists in 40-60% of lung cancer cases. METHODS:In a two-stage case-control ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2008.077107
更新日期:2009-10-01 00:00:00
abstract::A case of seminoma of the testis complicated by an extensive granulomatous reaction is reported. This reaction was so florid that a benign condition was initially considered until further material for histology was examined and the correct diagnosis made. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.691.334
更新日期:1983-05-01 00:00:00
abstract::Severe acute respiratory syndrome (SARS) is a newly emerged infectious disease with a significant morbidity and mortality. The major clinical features include persistent fever, chills/rigor, myalgia, malaise, dry cough, headache, and dyspnoea. Older subjects may present without the typical febrile response. Common lab...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2004.020263
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:To identify the consultation activities of clinical ethics committees (CECs) in the UK and the views of CEC chairpersons regarding such activities. METHODS:An anonymous, password-protected online questionnaire was sent by e-mail to 70 CEC chairpersons. The questionnaire contained 14 items. RESULTS:Of the 70...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2008.075879
更新日期:2009-09-01 00:00:00
abstract::This is a case report of a boy who presented with unilateral foot drop approximately 1 year after traumatic injury from skateboarding. Exploratory surgical operation was eventually performed, and histological examination of the surgical specimen revealed leprous peripheral neuropathy of the peroneal nerve. The patient...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.70.820.111
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To determine changes in hepatitis B virus (HBV) prevalence across three different time periods in pregnant women. METHODS:This was a retrospective study of pregnant women attending four healthcare centres between January 1995 and May 2015. Data for serum hepatitis B surface antigen (HBsAg) and anti-HBs level...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133876
更新日期:2016-09-01 00:00:00
abstract::Quantitative lipoprotein level data was obtained from healthy subjects and patients with ischaemic heart disease or peripheral vascular disease in four European communities. Hypertriglyceridaemia, due mainly to an increase in VLDL triglyceride, was commoner in London and Uppsala than in Naples and Geneva. In three com...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::It is a paradigm in cancer treatment that early detection and treatment improves survival. However, although screening measures lead to a higher rate of detection, for small bulk localised prostate cancer it remains unclear whether early detection and early treatment will lead to an overall decrease in mortality. The ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.78.924.590
更新日期:2002-10-01 00:00:00
abstract::Alcohol is a major cause of liver cirrhosis in the Western world and accounts for the majority of cases of liver cirrhosis seen in district general hospitals in the UK. The three most widely recognised forms of alcoholic liver disease are alcoholic fatty liver (steatosis), acute alcoholic hepatitis, and alcoholic cirr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.76.895.280
更新日期:2000-05-01 00:00:00
abstract::We describe the case of an acromegalic woman with primary infertility who was treated with clomiphene, and subsequently developed pituitary apoplexy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.72.845.172
更新日期:1996-03-01 00:00:00
abstract::Chemotherapy-induced nausea and vomiting (CINV) remains one of the most debilitating toxicities associated with cancer treatment. In recent decades, significant strides have been made in our understanding of the pathophysiology of CINV, making way to more effective targeted pharmacotherapies, especially 5-hydroxytrypt...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2014-132969
更新日期:2016-01-01 00:00:00
abstract::Paget's disease of bone is a relatively common condition in the UK affecting up to 5% of the population over the age of 55 years with particularly high prevalence in the North West of England. The majority of those affected are asymptomatic. Its precise cause remains unknown, and until recently, choice of treatment of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.856.69
更新日期:1997-02-01 00:00:00
abstract::Mathematical techniques are well suited to analysis of growth data. In the past there has been much emphasis on the mathematical description of shape and changes of shape as exemplified by the allometric equation. More recently these methods have been less popular and shape analysis has been handled largely by modern ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract::The effect of graded exercise on the secretion of cortisol, testosterone, prolactin, growth hormone, thyroid stimulating hormone (TSH), luteinizing hormone and follicle stimulating hormone (FSH) is reported. While cortisol, prolactin, growth hormone and testosterone rise during the period of exercise, a rise in lutein...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.644.373
更新日期:1979-06-01 00:00:00
abstract::The role of prostaglandins in inflammation is still disputed. Some workers have attempted to fit prostaglandins into a simple model, i.e. inflammatory leads to chemical mediator leads to vascular response. Recent work has shown that this approach may be misleading. An alternative model is proposed, involving the inter...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.625.660
更新日期:1977-11-01 00:00:00
abstract::Candida albicans peritonitis developed in a 48-year-old man with a perforated gastric ulcer who subsequently was treated with intravenous amphotericin B. The drug penetrated well into the inflamed peritoneal cavity and eradicated the organism from the peritoneal fluid. Nevertheless, at post-mortem, Candida organisms w...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.631.340
更新日期:1978-05-01 00:00:00
abstract::Current maintenance immunosuppressive regimens for transplantation are based on three classes of drugs: corticosteroids, immunophilin-binding agents (eg, cyclosporin and tacrolimus), and antimetabolites (eg, azathioprine and mycophenolate). Drugs from the various classes inhibit the immune system at different points a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.861.386
更新日期:1997-07-01 00:00:00
abstract::Two patients with severe dothiepin intoxication are described. The management of these cases is discussed and we draw attention to the prolonged elimination half-life of dothiepin and its metabolites, and the implication for treatment. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.704.442
更新日期:1984-06-01 00:00:00
abstract::Healthcare workers have a high risk of occupational exposure, more so in developing countries, with high incidence of blood borne diseases and prevalence of unsafe practices. Among the various blood borne diseases, the most common and important ones are HIV infection, hepatitis B, and hepatitis C. Most of the occupati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.79.932.324
更新日期:2003-06-01 00:00:00