amphotericin-b and Anemia--Hemolytic--Autoimmune

To summarize the epidemiology, clinical features, treatment, and outcome of cryptococcal meningitis (CM) in autoimmune hemolytic anemia (AIHA) patients and to provide a reference for the prevention and control of AIHA complicated with CM, we evaluated five cases of CM in patients with AIHA treated in our hospital from 2003 to 2013 and eight related foreign cases. All of the clinical isolates were Cryptococcus neoformans var. grubii and grouped into the VNI genotype and serotype A. The clinical features exhibit significant features. Headache, nausea, and fever are common symptoms of AIHA complicated with CM. The early clinical manifestations lack specificity, which may lead to delayed diagnosis and treatment. Long-term use of prednisone (≥15 mg day(-1)), poor control of anemia, and splenectomy are risk factors for AIHA complicated with cryptococcal infection. The combination of intravenous amphotericin B and oral 5-fluorocytosine remains the preferred treatment for AIHA complicated with CM.

Topics: Adolescent; Adult; Aged; Amphotericin B; Anemia, Hemolytic, Autoimmune; Antifungal Agents; Cryptococcus neoformans; Female; Flucytosine; Genotype; Humans; Male; Meningitis, Cryptococcal; Middle Aged; Serogroup; Young Adult

Topics: Absidia; Aged, 80 and over; Amphotericin B; Anemia, Hemolytic, Autoimmune; Antibodies, Monoclonal, Murine-Derived; Antifungal Agents; Combined Modality Therapy; Cryoglobulinemia; Cyclophosphamide; Debridement; Dexamethasone; Fatal Outcome; Female; Humans; Immunocompromised Host; Immunosuppressive Agents; Leukemia, Lymphocytic, Chronic, B-Cell; Liposomes; Mucormycosis; Purpura, Thrombocytopenic, Idiopathic; Rituximab

A human immunodeficiency virus-negative 63-year-old male with autoimmune hemolytic anemia presented with decreased vision, photophobia and hearing loss. After initial testing seemed consistent with sarcoidosis, he was found to have disseminated Cryptococcus with a cryptococcoma of the left eye. Treatment with systemic anti-fungal therapy improved the patient's condition.

Topics: Amphotericin B; Anemia, Hemolytic, Autoimmune; Antifungal Agents; Cryptococcosis; Cryptococcus; Drug Therapy, Combination; Eye Infections, Fungal; Fluconazole; Flucytosine; HIV Seronegativity; Humans; Lung Diseases, Fungal; Magnetic Resonance Imaging; Male; Meningitis, Fungal; Middle Aged; Recurrence; Retinal Diseases; Tomography, X-Ray Computed; Vitreous Body

Visceral Leishmaniasis (VL) is a vector-borne zoonosis endemic in Southern Italy whose usual clinical features include fever, splenomegaly, pancytopenia and hypergammaglobulinemia. The clinical and biochemical picture may be misleading in patients with immunodeficiency diseases hampering the diagnosis. We describe a VL case in a patient whose spleen had been removed and who had Common Variable Immunodeficiency and Evans syndrome.

Topics: Amphotericin B; Anemia, Hemolytic, Autoimmune; Antiprotozoal Agents; Common Variable Immunodeficiency; Fever; Glucocorticoids; Humans; Immunization, Passive; Immunocompromised Host; Leishmaniasis, Visceral; Male; Middle Aged; Prednisone; Splenectomy; Thrombocytopenia

Topics: Amphotericin B; Anemia, Hemolytic, Autoimmune; Antiprotozoal Agents; Coombs Test; Humans; Leishmaniasis, Visceral; Liposomes

We report here on an eight-year-old boy who first developed acute intravascular hemolysis following therapy with amphotericin B (AmB) and subsequently a delayed hemolytic transfusion reaction due to alloantibodies. Although there is as yet no evidence for metabolism of AmB in vivo, the hemolysis appeared to be the result of sensitization against a degradation product of the drug. The patient's serum contained a hemagglutinating IgM antibody that reacted with all red blood cells (RBC) tested in the presence of plasma obtained from patients receiving AmB (ex vivo antigen), but not in the presence of their urine, AmB itself, or with AmB-pretreated RBC. These findings indicate that the antibody was directed against a degradation product of AmB, presumably a trace metabolite, that has not yet been identified.

Topics: Acute Disease; Amphotericin B; Anemia, Hemolytic, Autoimmune; Biotransformation; Child; Hemagglutination Tests; Hemoglobins; Humans; Isoantibodies; Male

Topics: Agranulocytosis; Amphotericin B; Anemia, Hemolytic, Autoimmune; Cryptococcosis; Female; Flucytosine; Humans; Meningitis; Middle Aged; Neutropenia; Prednisolone; Purpura, Thrombocytopenic