La Revue de médecine interne
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Autologous bone marrow transplantation for the treatment of solid tumors in adults remains an uncommon therapeutic approach. The feasibility of such high-dose therapies is clearly proved, especially with the advent of hematopoietic growth factors and the rescue by the peripheral stem cells to reduce the duration of the chemotherapy-induced myeloid aplasia. The question is to exactly define the place of high-dose therapy in the land of solid tumors. ⋯ The results of previous studies are disappointing. Moreover, occult medullary micrometastases involvement is frequent, once again even in limited diseases. However new therapeutic associations, as the ICE regimen (IFM, Carboplatin, VP-16) delivered as single or tandem therapy, have to be studied, especially as early consolidation therapy for the treatment of limited small-cell lung carcinomas.
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Infections due to Yersinia enterocolitica are usually limited to the bowel. When infection is generalized, the role of iron overload and iron chelation has been discussed. We report the case of a 55 year-old patient with sideroblastic anemia who received repetitive transfusions and deferoxamine for 4 years and heme arginate for 2 months, and who was admitted in our institution for Yersinia enterocolitica sepsis. Treatment by third-generation cephalosporins and aminoglycosides has allowed favorable outcome.
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Review Case Reports
[Unresectable giant hepatic hemangioma and Kasabach-Merritt syndrome].
The Kasabach-Merritt syndrome was first described in children with cutaneous hemangiomas, but it can exceptionally be associated with visceral hemangiomas, especially in adults. Clotting and fibrinolysis within the hemangioma are thought to cause the coagulopathy observed in the so-called Kasabach-Merritt syndrome. ⋯ But in the adult, the only radical alternative is surgical excision if technically feasible. We reported here the case of a 43 year-old woman with a giant unresectable hepatic hemangioma complicated with a Kasabach-Merritt syndrome.
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Case Reports
[Thrombotic thrombocytopenic purpura and ankylosing spondylarthritis. Apropos of a case].
The authors report a case of thrombotic thrombocytopenic purpura (TTP) which revealed a hitherto unrecognized ankylosing spondylitis. After a 4-year follow-up, the spondylitis is still progressing in its axial and/or peripheral form, and TTP has not relapsed. ⋯ The TTP-ankylosing spondylitis association is extremely rare: analysis of the literature yielded only one case. The authors discuss the hypothesis of a common triggering factor.