amphotericin-b and Anemia--Sickle-Cell

A 31-year-old patient with sickle-cell disease who had previous cholecystectomy developed acute onset of jaundice and abdominal pain. An endoscopic retrograde cholangiography demonstrated multiple filling defects within the bile ducts. Microscopic examination of "calculi" removed at surgery revealed that a fungal ball composed of Candida was the cause of biliary obstruction in this case. The patient eventually recovered after removal of the fungal masses and intrabiliary instillation of amphotericin.

Topics: Adult; Amphotericin B; Anemia, Sickle Cell; Candidiasis; Cholangiopancreatography, Endoscopic Retrograde; Cholestasis; Combined Modality Therapy; Gallstones; Humans; Male; Prognosis

The properties of erythrocytes used as carriers for drugs, enzymes, and DNA will be reviewed. One potential application is delivery of these substances to cells responsible for or capable of erythrophagocytosis and are located primarily in the liver and the spleen. A second potential application depends on the ability of loaded cells to survive for substantial periods of time in the circulation after reinfusion. Circulating cells used as drug carriers may be able to modify the pharmacokinetics of administered drugs and if used as enzyme carriers, they may be able to alter the level of various substances in the plasma. Erythrocytes in vitro may fuse with recipient cells, introducing their contents in a functional form into recipient cells. Nucleic acids, either RNA or DNA, as well as enzymes or other entrapped substances, may be transferred in this manner.

Topics: Amphotericin B; Anemia, Sickle Cell; Animals; Cytarabine; Daunorubicin; Erythrocyte Deformability; Erythrocyte Membrane; Erythrocytes; Excipients; Glucosylceramidase; Glucuronidase; Hemolysis; Humans; Methotrexate; Molecular Weight; Phagocytosis; Pharmaceutical Preparations

We report a 23-year-old thalassodrepanocytic man who contracted leishmaniasis. The diagnostic difficulties related to some overlapping features between the two conditions are discussed. To the best of our knowledge, this is the first reported occurrence of leishmaniasis in a thalassodrepanocytic patient.

Topics: Adult; Amphotericin B; Anemia, Sickle Cell; Antiprotozoal Agents; Diagnosis, Differential; Follow-Up Studies; Humans; Italy; Leishmaniasis, Visceral; Male; Splenectomy; Time Factors; Treatment Outcome

The use of indwelling central catheters for long-term administration of hyperalimentation, chemotherapy or other intravenous therapies is increasing. This unusual presentation of a catheter-induced right atrial thrombus was complicated by fungal infection. We present a case of a paediatric sickle-cell patient who underwent surgical removal of a right atrial thrombus secondary to fungal (Candida tropicalis) endocarditis from an indwelling catheter. Successful thrombus removal utilizing cardiopulmonary bypass and subsequent discharge underscores the importance of surgical therapy in treating this important complication.

Topics: Amphotericin B; Anemia, Sickle Cell; Antifungal Agents; Blood Transfusion; Candidiasis; Cardiopulmonary Bypass; Catheterization, Central Venous; Child, Preschool; Combined Modality Therapy; Embolism; Endocarditis; Heart Atria; Heart Diseases; Humans; Intraoperative Complications; Male; Postoperative Complications; Respiratory Tract Infections; Thrombosis

A study has been carried out into the effects of clinically important antisickling and anaesthetic substances and ionophoric antibiotics on the activities of (Na+, K+)- and (Ca+2, Mg2+)-ATPases of the human erythrocyte membrane. In general, these drugs, with the exception of nystatin, inhibit both types of enzymic activities but with varying degrees of efficacy. (Ca2+, Mg2+)-ATPases was more sensitive to the lipophilic anaesthetics and (Na+,K+)-ATPase to the ionophoric antibiotic, amphotericin B. These results are explained in the light of the partition coefficients of these drugs in erythrocyte membranes, their effects on the fluidity of the erythrocytes membranes, the changes they induce in the permeability properties of erythrocytes and the subsequent effect of procaine on sickling of erythrocytes, and their potential interaction with specific membrane components.

Topics: Adenosine Triphosphatases; Alfaxalone Alfadolone Mixture; Amphotericin B; Anemia, Sickle Cell; Erythrocyte Membrane; Hemoglobin, Sickle; Humans; Nystatin; Procaine

We present the findings in a patient having sickle cell disease who developed multilobar pneumonia. Cultures of bronchial aspirates and histologic specimens grew Cryptococcus neoformans. There was neither spontaneous clearing of the infection nor a response to bactericidal antibiotics. The patient had no underlying malignant neoplasm or immunodeficiency as indicated by history, physical examination, and specialized tests of humoral and cell-mediated immunity.

Topics: Adult; Amphotericin B; Anemia, Sickle Cell; Anti-Bacterial Agents; Cryptococcosis; Humans; Male; Pneumonia; Radiography

Topics: Adult; Amphotericin B; Anemia, Sickle Cell; Bone and Bones; Diphosphonates; Female; Humans; Hypercalcemia; Kidney; Lupus Erythematosus, Systemic; Male; Middle Aged; Nephritis; Radionuclide Imaging; Technetium; Technetium Tc 99m Medronate