Case studies blood transfusion

Rare cases of hemolytic anemia, including fatalities, have been reported with the administration of the cephalosporins. The patient should be monitored for anemia If a patient experiences anemia within 2 to 3 weeks after the start of cephalosporin therapy, drug-induced anemia should be considered. If hemolytic anemia is suspected, the primary health care provider will discontinue the drug therapy. The patient may require blood transfusions to correct tire anemia. Frequent hematological studies may be required. 

Hepatic Effects. A single case study was located regarding hepatic effects in humans after oral exposure to 1,4-dichlorobenzene. In this case report, the author describes a 3-year-old boy who had been playing with crystals containing 1,4-dichlorobenzene for 4-5 days before being admitted to the hospital. On admission, the boy was jaundiced and his mucous membranes were pale. After a blood transfusion. 

Level II (non-randomized) evidence of effect is available supporting the efficacy of HBO for the treatment of severe radiation-indnced hemorrhagic cystitis refractory to conventional measures. The largest study describes 40 patients treated for 20 sessions of HBO." ° A total of 37 of the 40 patients showed marked and durable (up to 5 years) reductions in bleeding frequency, including need for blood transfusions, and no adverse effects were reported. A consecutive series of 20 patients treated between 1989 and 1992 reported improvement of hematuria in 90% of cases." Similar experiences based on smaller patient numbers are available." " No adverse effects of HBO were reported in any of these studies. 

On the wider scale, ionised calcium in sera measured with the calcium ion-selective electrode have helped in studying the direct effect of calcium on the hyperparathyroidism of chronic renal failure when it was shown that rats on low calcium diet developed larger parathyroids and more severe bone disease at the end of four weeks while diets with above normal calcium levels produced no additional benefits [130]. Other studies include the relation between hypercalcemia and normal ionised serum calcium in a case of myelomatosis [86], the detection of hypocalcemia in susceptible neonates [68], and studies on serum ionised calcium changes following citrated blood transfusion in anaesthetised subjects [93]. The transfusion studies showed six patients during anaesthesia to have a decrease of 0.135 mmol dm" after 500 cm and 0.15 mmol dm" after 1000 cm blood, respectively. However, the calcium ion concentration increased by a mean of 0.075 mmol dm" in 10 min following complete infusion of the blood [93]. 

In a case-control study in children undergoing spinal surgery, seven cases of TRALI were compared with 28 controls [13 ]. Three children with TRALI had received blood transfusions from their mother compared with two of the 28... 

Dunbar N, Cooke M, Diab M, Toy P. Transfusion-related acute lung injury after transfusion of maternal blood a case-control study. Spine (Phila Pa 1976) 2010 ... 

Observational studies In a retrospective study in South Korea of linezolid in combination with other second-line drugs in 11 patients with intractable multidrug resistant tuberculosis, nine had serious adverse events [145 ]. Eight patients developed a peripheral neuropathy in the legs after a median of 4 months linezolid was withdrawn in these cases. Three patients developed an optic neuropathy, including two who had a peripheral neuropathy, after a median of 4 months. Two patients developed anemia requiring blood transfusion. 

Haematological There have been further descriptions, in case reports and studies [82, 83 84 85 -], of anaemia managed with erythropoietin, blood transfusion or discontinuation of treatment. 

In 1919 a case was reported of asthma caused by allergy to horse dander, which had been passively transferred by blood transfusion (1), and in 1921 Praus-nitz and Kiistner (2) performed their famous passive transfer of a positive skin test, later called the PK test. Concurrently and independently. Dr. Arent de Besche in Norway was carrying out similar studies using serum from patients allergic to horses. 

Transmission of viral hepatitis continues to be a serious problem related to the transfusion of whole blood, cellular blood components, and to a lesser degree plasma-derived prodncts (8,155). It is difficult and probably impossible to obtain complete data on the true incidence of hepatitis transmitted by blood or blood products the incubation time is long, mild anicteric cases are not recognized, and systematic follow-up studies of transfused patients are difficnlt and expensive (156). In addition, the epidemiology of viral hepatitis is different in different regions. 

HTLV-1 and HTLV-2 The human T cell lymphotropic virus type I (HTLV-I) is endemic in some areas of Japan, the Caribbean, and Africa, and has been associated with adult T cell leukemia. In Japan, seroconversion has been observed when anti-HTLV-I-negative patients were transfused with seropositive blood or blood components in one study the conversion rate was 62% (177). However, no case of transfusion-associated adult T cell leukemia has been reported to date (184,185). HTLV-II was originally isolated from a patient with hairy cell leukemia, but... 

To date studies have shown that patients who develop Creutzfeldt-Jakob disease do not have a history of a higher rate of transfusion or treatment with blood products. Likewise, those who have received blood from donors who subsequently prove to have Creutzfeldt-Jakob disease do not acquire an increased risk. Furthermore, animal experiments have shown that blood and blood products are very low risk materials in transfer experiments from diseased to healthy animals. AH the same, certain authorities are now considering the exclusion of donors from families with known cases of classic Creutzfeldt-Jakob disease. 

Severe combined immunodeficiency (SCID) due to adenosine deaminase deficiency (ADA) exhibits autosomal recessive inheritance, and may account for up to 209 of cases (l). Accumulation of intracellular toxic deoxynucleotides and/or S-adenosyl homocysteine particularly in T cells, is considered responsible for the severe lymphoid depletion and dysfunction observed in affected children (2). Unlike other forms of SCID, this variety is amenable to enzyme replacement therapy using regular fresh irradiated red blood cell transfusions as the source of enzyme. Another form of therapy suggested from in vitro studies, is the use of deoxycytidine which theoretically would act as a competitive substrate for deoxycytidine kinase, the enzyme considered responsible for the intracellular accumulation of deoxy-ATP (dATP). This study reports our experience of various treatments in three ADA deficient children. 

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