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Drug-induced Bone Marrow Suppression

Drug Induced Hypoplasia of Bone Marrow


Presentation

  • الصفحة 272 - Salmon SE: A clinical staging system for multiple myeloma: Correlation of measured myeloma cell mass with presenting clinical features, response to treatment and survival. Cancer 36:842-854, 1975 6. ‏[books.google.com]
  • In the present study, an elderly patient admitted to the ICU presented with thrombocytopenia, which was associated with TZP treatment.[spandidos-publications.com]
  • The clinical presentation depends in part upon the etiology and pathogenesis of the agranulocytosis: Immune forms may present days to weeks after beginning the drug and are often acute with explosive symptoms.[wikidoc.org]
  • DIAGNOSIS AND CLINICAL PRESENTATION Agranulocytosis is characterized by a neutrophil granulocyte count 0.5 109/l with no relevant decrease in haemoglobin and platelet counts.[flipper.diff.org]
  • Pertinent laboratory data on his initial presentation can be seen in Table 2. His ANC was 360 cells/mcL (neutropenic). The patient had not demonstrated neutropenia from the time of his diagnosis until his ED presentation.[ptcommunity.com]
Subcutaneous Bleeding
  • The patients with thrombocytopenia associated with TZP may report severe bleeding at a number of locations, including gastrointestinal tract bleeding, a cerebral hemorrhage or subcutaneous bleeding ( 10 ) The mechanism by which TZP causes thrombocytopenia[spandidos-publications.com]
Anemia
  • الصفحة 15 - Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW, Correction of the anemia of end-stage renal disease with recombinant human erythropoietin: Results of a combined phase I and II clinical trial. ‏[books.google.com]
  • “Aplastic anemia may be congenital, or develop from Franconi anemia, an inherited disorder,” says Kassim.[everydayhealth.com]
  • […] aplastic anemia D61.01 Constitutional (pure) red blood cell aplasia D61.09 Other constitutional aplastic anemia D61.1 Drug-induced aplastic anemia D61.2 Aplastic anemia due to other external agents D61.3 Idiopathic aplastic anemia D61.8 Other specified[icd10data.com]
  • 55–57 ) that are likely to be part of the treatment for aplastic anemia.[epilepsy.com]
  • Aplastic or hypoplastic anemia can be idiopathic in nature, or it can develop from secondary causes. Myelodysplastic anemia also can cause pancytopenia. Myelophthisic anemia may result from marrow destruction because of tumor invasion or granulomas.[emedicine.medscape.com]
Anemia
  • الصفحة 15 - Eschbach JW, Egrie JC, Downing MR, Browne JK, Adamson JW, Correction of the anemia of end-stage renal disease with recombinant human erythropoietin: Results of a combined phase I and II clinical trial. ‏[books.google.com]
  • “Aplastic anemia may be congenital, or develop from Franconi anemia, an inherited disorder,” says Kassim.[everydayhealth.com]
  • […] aplastic anemia D61.01 Constitutional (pure) red blood cell aplasia D61.09 Other constitutional aplastic anemia D61.1 Drug-induced aplastic anemia D61.2 Aplastic anemia due to other external agents D61.3 Idiopathic aplastic anemia D61.8 Other specified[icd10data.com]
  • 55–57 ) that are likely to be part of the treatment for aplastic anemia.[epilepsy.com]
  • Aplastic or hypoplastic anemia can be idiopathic in nature, or it can develop from secondary causes. Myelodysplastic anemia also can cause pancytopenia. Myelophthisic anemia may result from marrow destruction because of tumor invasion or granulomas.[emedicine.medscape.com]
Swelling
  • […] symptoms: fatigue pale skin, lips, and nail beds increased heart rate tiring easily with exertion dizziness shortness of breath Reduced white blood cells produce classic symptoms of a weak immune system: fever and chills rash diarrhea signs of infection (swelling[diagnose-me.com]
  • Signs of infection may also be present, including swelling, redness or an area that is warm to the touch. Other common neutropenia side effects include diarrhea and rash.[mesothelioma-aid.org]
  • Signs of an allergic reaction include hives; difficulty breathing; and swelling of the face, lips, tongue, or throat.[ehj.eg.net]
  • Side-effects include severe febrile reactions (high fevers); skin reactions (increased coloration- hyperpigmentation) as well as skin inflammation and swelling and thickening of the nail beds.[healthcommunities.com]
  • Tell your healthcare team if you develop redness, swelling, pain, burning or stinging at the injection site. Inflamed vein An intravenous (IV) needle or catheter can cause the vein to become inflamed (a condition called phlebitis).[cancer.ca]
Sepsis
  • Seven days following treatment with daily subcutaneous injection of 270 micrograms rHu GM-CSF combined with antibiotics and glucocorticosteroids, granulocytes reappeared in the peripheral blood and the sepsis resolved.[ncbi.nlm.nih.gov]
  • This is called sepsis. Diseases of the immune system Diseases of the immune system, such as HIV, which destroy T lymphocytes Hypersplenism This is caused by enlargement of spleen that destroys the blood cells leading to leukopenia as well as anemia.[news-medical.net]
  • DIA remains a serious adverse event because of the occurrence of severe sepsis with severe deep infections (such as pneumonia), septicemia, and septic shock in around two thirds of patients.[ehj.eg.net]
  • When the granulocyte count falls below 500 cells/mm 3, the risk of infection and sepsis is significant, an observation in accord with similar findings in other disease states.[hivinsite.ucsf.edu]
Refractory Anemia
  • Finally, it may arise from lymphoproliferative diseases (eg, lymphomas, chronic lymphocytic leukemia) or collagen vascular diseases (eg, systemic lupus erythematosus, refractory anemia), or it may occur during pregnancy.[emedicine.medscape.com]
Pulmonary Disorder
  • Hematologic and pulmonary disorders. In: Ettinger AB and Devinsky O, eds. Managing epilepsy and co-existing disorders. Boston: Butterworth-Heinemann; 2002;209–228. With permission from Elsevier ( www.elsevier.com ).[epilepsy.com]
Increased Appetite
  • Although sodium valproate is generally associated with increased appetite and weight gain, it can also be associated with anorexia, nausea, vomiting, and weight loss. Author Contributions All authors contributed equally to preparing the case report.[journals.plos.org]
Purpura
  • Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. ‏[books.google.com]
  • Abstract Cortisone, hydrocortisone, and adrencorticotropic hormone (ACTH) have been employed therapeutically in a variety of blood dyscrasias. 1 These compounds have been found particularly effective in thrombocytopenic purpura, 2 acquired hemolytic anemias[annals.org]
  • Autoimmune thrombocytopenic purpura in homosexual men. Ann Intern Med 1982;96:714-717. 28. Ratner L. Human immunodeficiency virus-associated autoimmune thrombocytopenic purpura: A review. Am J Med 1989;86:194-198. 29.[hivinsite.ucsf.edu]
  • The preliminary diagnosis of the patient was idiopathic thrombocytopenic purpura.[spandidos-publications.com]
  • They have hemorrhages and purpura secondary to thrombocytopenia, are weak and pale because of anemia, and tend to have infections as the result of leukopenia. The course of the disease is determined by the severity of the bone marrow suppression.[epilepsy.com]
Slurred Speech
  • Case report A 76-year-old male patient with a 20-year history of hypertension was admitted to the intensive care unit (ICU) of Ningbo First Hospital (Ningbo, China) in February 2013 complaining of dizziness, vomiting and slurred speech.[spandidos-publications.com]

Workup

  • As part of the workup for localization of infection, appropriate radiographs (e.g. chest images) are indicated. Other imaging studies can be carried out on the basis of the specific indications of each case.[ehj.eg.net]

Treatment

  • The haemopoietic growth factors are relatively new additions to the treatment of drug-induced bone marrow suppression. Treatment with growth factors may induce primitive cells to enter into cell cycle.[ncbi.nlm.nih.gov]
  • الصفحة 336 - EORTC classification for primary cutaneous lymphomas: a proposal from the Cutaneous Lymphoma Study Group of the European Organization for Research and Treatment of Cancer. Blood 90: 354-371. ‏[books.google.com]
  • Your doctor may notice a drop in blood cell counts about a week after treatment. While it’s a side-effect of treatment itself, suppression of bone marrow can lead to a new set of side effects that may need to be monitored by your doctor.[share.upmc.com]
  • Fatigue can happen within days after a chemotherapy treatment and can last long after treatment ends. It also tends to be worse when you are having other treatments, such as radiation therapy. Fatigue usually gets better over time.[cancer.ca]
  • Use of Lnz is increasing as newer (Group V) drug for the treatment of MDR and XDR pulmonary TB.[jacpjournal.org]

Prognosis

  • (Outcomes/Resolutions) The prognosis of Drug-Induced Thrombocytopenia is usually excellent, if the drug causing the condition is identified and discontinued, when possible In some, the prognosis may get complicated, if there is large amount of bleeding[dovemed.com]
  • Bone-Marrow Disease Anemia and the Link to Blood Cancer The prognosis for bone marrow disease is not encouraging — myelodysplastic syndromes, aplastic anemia, and paroxysmal nocturnal hemoglobinuriacan each progress to blood cancer.[everydayhealth.com]
  • Prognosis, response to therapy, and prevalence of antibody to the retrovirus associated with the acquired immunodeficiency syndrome. Ann Intern Med 1985;103:542-545. 36. Oksenhendler E, Bierling P, Farcet JP, et al.[hivinsite.ucsf.edu]

Etiology

  • Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10data.com]
  • The clinical presentation depends in part upon the etiology and pathogenesis of the agranulocytosis: Immune forms may present days to weeks after beginning the drug and are often acute with explosive symptoms.[wikidoc.org]
  • These etiologies involve the following: A decrease in or damage to the hematopoietic stem cells and their microenvironment, resulting in hypoplastic or aplastic bone marrow Maturation defects, such as in vitamin B-12 or folate deficiency Differentiation[emedicine.medscape.com]
  • Aplastic Anemia Study was carried out in the 1980s, several epidemiological studies have confirmed some previous findings or have uncovered drugs with a potential risk, such as antithyroid drugs, ticlopidine hydrochloride, spironolactone and clozapine ETIOLOGY[flipper.diff.org]
  • (Etiology) Drug-Induced Thrombocytopenia is caused through the usage of certain drugs.[dovemed.com]

Epidemiology

  • EPIDEMIOLOGY Idiosyncratic drug-induced agranulocytosis is a very rare disease. Annual incidence rates in Europe usually range from 1.6 to 9.2 cases per million population per year.[flipper.diff.org]
  • Anemia in HIV infected adults: epidemiology, pathogenesis and clinical management. Curr Hematol Rep 4, 95 –102. [Google Scholar] Forna, F., Liechty, C. C., Solberg, P., Asiimwe, F., Were, W., Mermin, J., Behumbiize, P., Tong, T., Brooks, J.[jmm.microbiologyresearch.org]
  • Epidemiology [ 5 ] Inherited causes account for 10-15% of cases of bone marrow failure, but for 30% of cases presenting in children. It can occur at any age, with a peak for inherited syndromes in pre-school children.[patient.info]
  • Occupational factors in the epidemiology ofebemicalty induced lymphoid and hcmopoietic cancers, in toxicology of the blood and bone marrow. Edited by R.D., Iron, New York, Raven Press, 1985, pp. 149-77. 16.[jpma.org.pk]
  • Epidemiology and Demographics Agranulocytosis has a reported incidence from approximately 1 to 10 cases per million population per year. An association with drug use can be found in about 70 percent of cases.[wikidoc.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology and management of thrombocytopenia in bone marrow failure: possible clinical applications of TPO receptor agonists in aplastic anemia and myelodysplastic syndromes. Int J Hematol. 2013 Jul. 98(1):48-55. [Medline].[emedicine.medscape.com]
  • Pathophysiology & Etiology Most cases of neutropenia are due to decreased granulocyte production or less commonly increased destruction. * Acquired neutropenia is most often due to accelerated turnover, usually resulting from immunologic mechanisms.[wikidoc.org]
  • Pathophysiologic mechanisms, clinical features and treatment of idiopathic neutropenia. Expert Rev Hematol 2008; 1 :217-229. 3. Palmblad JE, von dem Borne AE. Idiopathic, immune, infectious, and idiosyncratic neutropenias.[ehj.eg.net]
  • PATHOPHYSIOLOGY Neutropenia is defined as having an absolute neutrophil count (ANC) of less than 500 cells/mm 3 and is a common adverse event associated with many cytotoxic chemotherapy agents. 8 During cytotoxic chemotherapy, neutropenia typically occurs[ptcommunity.com]

Prevention

  • A comparison of filtered leukocyte-reduced and cytomegalovirus (CMV) seronegative blood products for the prevention of transfusion-associated CMV infection after marrow transplant. Blood 1995; 86:3598-3603. ‏[books.google.com]
  • Additionally, treatment measures including platelet transfusion, plasmapheresis, and corticosteroid medication may be required, in some cases of severe hemorrhage, to bring platelet count to normal range and prevent further bleeding episodes The prognosis[dovemed.com]
  • Called also myelophthisis and myelosuppression. labor suppression in the nursing interventions classification, a nursing intervention defined as controlling uterine contractions prior to 37 weeks of gestation to prevent preterm birth.[medical-dictionary.thefreedictionary.com]
  • The use of azathioprine (Imuran; Azasan) is common for a number of conditions, some of which include the prevention of rejection of organ transplantation, inflammatory bowel disease (in particular Crohn's disease), rheumatoid arthritis, systemic lupus[ebmconsult.com]
  • […] painful or warm to the touch) Reduced platelets produce classic excess bleeding symptoms: easy bruising bleeding: nose bleeds, or bleeding gums or mouth tiny red spots on the skin (petechiae) blood in the urine dark or black bowel movements Treatment and Prevention[diagnose-me.com]

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