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Biomedical subjects

M Sivakumaran

Publications and source records attributed to M Sivakumaran.

At least 37 records · Page 2Linked to original sources
PubMed1998

Primary cardiac lymphoma: death from cardiac asystole after attaining second complete remission.

A patient with primary high grade cardiac lymphoma, diagnosed by pericardial fluid cytology, achieved complete remission with chemotherapy. After a relapse 11 months later, a second complete remission was attained with radiotherapy and chemotherapy but the patient suffered a fatal cardiac asystole during intensification therapy. A review of the recent literature suggests that prognosis for this rare extra nodal lymphoma has markedly improved as a result of early diagnosis and prompt institution of aggressive antilymphoma therapy.

Death, Sudden, Cardiac↗
PubMed1998

An unusual cutaneous manifestation of myelodysplastic syndrome: "pseudo-Koebner phenomenon".

An unusual and hitherto unreported complication of myelodysplastic syndrome is reported: the "pseudo-Koebner phenomenon." The skin lesions were characterised by exuberant "fleshy" masses at the sites of intravenous cannulation and skin trauma, and by histological evidence of chronic inflammation with focal necrosis and abscess formation. No evidence of dermal infiltration by malignant haemopoietic cells was seen. The exact aetiopathology of the phenomenon is unclear but an inappropriate and exaggerated inflammatory response owing to aberrant mediator mechanisms that are known to occur in some cases of myelodysplastic syndrome may be implicated.

Catheterization, Peripheral↗
PubMed1998

Lymphoma associated bone marrow necrosis with raised anticardiolipin antibody.

A case of high grade B cell lymphoma presented with bone marrow necrosis, followed by development of extensive marrow fibrosis, the evolution of which was documented by serial magnetic resonance imaging and bone marrow trephine histology. A markedly raised anticardiolipin antibody titre at diagnosis suggests that lymphoma associated antiphospholipid syndrome may have contributed to the aetiology of the bone marrow necrosis.

Aged↗
PubMed1998

Unusual aetiology of persistent back pain in a patient with multiple myeloma: infectious discitis.

A 47 year old man with multiple myeloma presented with persistent back pain caused by infectious discitis. Aspiration of the affected vertebral disc space was carried out, guided by computed tomography, and microbiological examination of the aspirate revealed Staphylococcus aureus and Mycobacterium tuberculosis. Antituberculous and antistaphylococcal antibiotic treatment resulted in a dramatic clinical response with complete resolution of the vertebral abscess. Detailed radiological and microbiological investigations are necessary to diagnose unusual causes of chronic bone pain such as discitis or infectious bone disease in patients with multiple myeloma.

Discitis↗
PubMed1997

Immunological abnormalities of chronic large granular lymphocytosis.

Chronic large granular lymphocytosis is a relatively common condition and comprises a clinically heterogenous group of patients. Phenotypically these can be divided into CD3+ (T cell) and CD3-(NK cell) expansions. They are characterized by a benign clinical course and a mild lymphocytosis, though a specific subgroup have a history of auto-immune disease and cytopenias. In order to develop a better understanding of the immunological abnormalities associated with this condition we examined systematically serum samples from 92 such patients for the presence of auto-antibodies, acute phase proteins and immunoglobulin levels. Auto-antibodies were found in 34% of patients and rheumatoid factor in 26%, though only half of these had active arthritis. Anti-neutrophil antibodies were negative in all cases. Quantitative immunoglobulin abnormalities were frequent with a distinct paraprotein present in three patients. The high incidence of multiple immunological abnormalities in these patients ranged from polyclonal hypergammaglobulinaemia and auto-antibodies through to monoclonal gammopathy. The aetiology of these abnormalities was unclear and undoubtedly complex, and should necessarily form part of the diagnostic investigations for all patients with persistent large granular lymphocyte expansions.

Antibodies, Antinuclear↗
PubMed1997

The presence of free infectious cytomegalovirus (CMV) in the plasma of donated CMV-seropositive blood and platelets.

An in vitro study was carried out to determine the presence of free infectious CMV in the supernatant of donated units of blood and platelets which were known to be CMV seropositive. One sample was taken from each of 10 units of CMV-seropositive platelet donations which were 4 days old. Ten units of seropositive blood were sampled at intervals over their storage lifespan. Each sample was divided into two and thrombin was added to one of them. The samples were all prepared by centrifugation. The resulting supernatant from the clotted samples was used in in vitro culture studies using the MRC-5 cell line to ascertain the infectivity of the samples. The anticoagulated supernatants were subjected to PCR analysis to detect the presence of free genomic CMV DNA. All of the units of blood and platelets tested positive for the presence of genomic CMV DNA by PCR. Seven out of the 10 units of blood were culture positive from samples taken 3-4 weeks into their shelf-life. None of the platelet samples was culture positive. The cultures of supernatants taken from seropositive blood were negative when the units were fresh, but further into their storage life, the cultures became positive, indicating that infectious material was released into the supernatant during storage, presumably due to the breakdown of intact white cells.

Blood Donors↗
PubMed1996

Osteoporosis and vertebral collapse following low-dose, low molecular weight heparin therapy in a young patient.

Osteoporosis is a well-recognized complication of long-term heparin (unfractionated) therapy. It has been suggested that the low molecular weight heparins (LMWH) have a lower potential to cause osteopenia than the unfractionated preparations. We report a case of a 29-year-old woman who developed osteoporosis and pathological fracture of lumbar vertebrae following treatment with low dose LMWH (dalteparin) for 3 months. The aim of this report is to alert clinicians to the potential risk of this complication with the prolonged use of LMWH preparations--an increasingly popular choice for long-term anticoagulation.

Adult↗
PubMed1996

Fatal bone marrow embolism in a patient with sickle cell beta + thalassaemia.

Sickle cell beta + thalassaemia is regarded as the mildest of the sickle cell haemoglobinopathy syndromes with a benign natural course. In contrast to sickle cell disease, severe life threatening complications are not usually associated with this genotype. A case of a 30 year old West Indian man who, previously asymptomatic for 10 years, sustained a fatal pulmonary bone marrow embolism, is reported. This case report illustrates that serious, even fatal, complications may occur in patients with this 'benign' condition and bone marrow embolism should be included in the differential diagnosis of acute crisis in these patients.

Bone Marrow Diseases↗
PubMed1996

Evaluation of the Pall RC100 leucocyte removal filters and the effect of air introduction on its performance.

We evaluated the efficiency of Pall RC100 leucocyte removal filters in processing two units of concentrated red cells for transfusion. Our results show that the filter is very effective in processing the first unit. However, 32% (5/16) of the filters evaluated allowed a leak of substantial numbers of white cells towards the end of the transfusion of the second unit of blood. Air introduction experiments showed that as little as 2 ml of air in the filter may cause major deterioration of the filter function.

Air↗
PubMed1996

Successful use of topical retinoic acid in severe dry eye due to chronic graft-versus-host disease.

Topical retinoic acid has proved to be of variable benefit in a number of dry eye disorders of disparate aetiology, in which squamous metaplasia with keratinization of ocular epithelium is present. Its exact role in patients with dry eye however remains in dispute. We describe a case of severe dry eye due to chronic graft-versus-host disease, which was refractory to conventional therapy but which responded remarkably to topical retinoic acid with reversal of conjunctival keratinization and marked resolution of symptoms.

Administration, Topical↗
PubMed1995

The role of pneumolysin and autolysin in the pathology of pneumonia and septicemia in mice infected with a type 2 pneumococcus.

Mice were infected intranasally with a serotype 2 pneumococcus, a pneumolysin-negative derivative (PLN-A), or an autolysin-negative derivative (AL-2). Numbers of wild type pneumococci were seen in the lung from approximately 12 h after infection and were first detected in the blood around this time. Immunofluorescent staining of lung sections showed that pneumolysin was produced in vivo. Pneumococcal infection resulted in alteration of the composition of the blood but not the bone marrow. Some of the hematologic changes did not occur after PLN-A. PLN-A had a slower growth rate in the lung and bacteremia was delayed. AL-2 was rapidly cleared from the lungs and was not detected in the blood. These events paralleled the pattern of histology in the lung, with the severity of inflammation reduced with PLN-A and no inflammation or hematologic changes with AL-2.

Analysis of Variance↗