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Biomedical subjects

R Monforte

Publications and source records attributed to R Monforte.

31 records · Page 2Linked to original sources

Chronic neutrophilic leukemia with marked myelodysplasia terminating in blast crisis.

A case of chronic neutrophilic leukemia (CNL) is reported. The patient had a history of bleeding, and showed sustained mature neutrophilic leukocytosis, hepatosplenomegaly, a high leukocyte-alkaline phosphatase score, elevated serum vitamin B12 and uric acid, and the presence of Döhle bodies in the neutrophils. In addition to the above typical features, marked myelodysplastic changes in the erythroid and megakaryocytic series were observed in the bone marrow. Three months after the diagnosis of CNL had been established, the hematological picture evolved into a blast crisis of monocytic type. Such findings give support to the statement of CNL as a distinct entity belonging to the spectrum of the myeloproliferative disorders.

Blast Crisis↗

Intestinal lymphoma in a patient with chronic lymphocytic leukemia of atypical phenotype: Richter's syndrome of unusual presentation.

A patient who developed an intestinal large-cell pleomorphic lymphoma during the course of untreated chronic lymphocytic leukemia (CLL) with an atypical phenotype (SIgG kappa) is reported. This is an unusual presentation of Richter's syndrome since RS with primary gastrointestinal involvement has only been described in two patients. In our case, immunological studies disclosed the same immunoglobulin (IgG kappa) in the large-cell pleomorphic lymphoma and on the surface of CLL cells, suggesting that both had arisen from the same clonal proliferation.

Aged↗

A possible pathogenic mechanism for rhabdomyolysis associated with multiple myeloma.

A case of a 44-year-old man in whom kappa light chain multiple myeloma and rhabdomyolysis (RDM) were diagnosed simultaneously is reported. Deposition of the kappa light chain in the cellular membrane of muscle fibers (observed with immunofluorescence techniques and ultrastructural examination) suggests a possible pathogenic mechanism for RDM.

Adult↗

Bronchial adenocarcinoma presenting as a lingual tonsillar metastasis.

We describe a case of a lingual tonsillar metastasis as the first manifestation of a bronchial adenocarcinoma. Tonsillar metastases infrequently become manifest before the diagnosis of the primary neoplasm. A review of the literature disclosed 89 cases of carcinoma metastasizing to the palatine tonsil, but no one has reported the involvement of the lingual tonsil. Our patient is the first described case of bronchogenic carcinoma with this unusual form of presentation and furthermore is also the first carcinoma metastasizing to the lingual tonsil.

Adult↗

High alcohol intake as a risk and prognostic factor for community-acquired pneumonia.

OBJECTIVE: To evaluate whether high alcohol intake is an independent risk factor for community-acquired pneumonia in middle-aged people and whether it confers a poor prognosis. METHODS: A two-phase study was performed. Risk factors for community-acquired pneumonia were evaluated in a case-control study of 50 patients and 50 controls. Prognostic factors and microbiologic and clinical features were then evaluated in a cohort study of the 50 middle-aged patients with community-acquired pneumonia. RESULTS: In the first study, the only independent risk factor for community-acquired pneumonia was high alcohol intake (P < .02). In the second study, patients with chronic alcoholism had a higher incidence of pneumonia caused by gram-negative bacilli (P < .03), as well as a higher incidence of Candida albicans (P < .03), Staphylococcus aureus (P < .0001), and gram-negative bacilli (P < .001) in the cultures of pharyngeal smears than did the nonalcoholics. Compared with nonalcoholic patients, alcoholic patients with pneumonia showed more severe clinical symptoms (P < .02), required longer intravenous treatment (P < .02) and longer hospital stay (P < .01), and had multilobar involvement and pleural effusion (both P < .01), as well as slower resolution of pulmonary infiltrates. The only prognostic factor for mortality was high alcohol intake (P < .03). CONCLUSIONS: High alcohol intake is the main risk factor for developing community-acquired pneumonia in middle-aged people. This situation also confers a worse prognosis in these patients, who should be treated with broad-spectrum antibiotics for a longer period.

Adult↗