São Paulo medical journal = Revista paulista de medicina
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Case Reports
Acquired hemoglobin H disease in a patient with aplastic anemia evolving into acute myeloid leukemia.
The prognosis of severe aplastic anemia has improved since the introduction of bone marrow transplantation and treatment with antithymocyte globulin. In contrast to the success of these protocols, studies with long term follow-up have shown the occurrence of clonal diseases such as paroxysmal nocturnal hemoglobinuria, myelodysplastic syndrome and acute leukemia in aplastic anemia. ⋯ We report the first case of a Brazilian patient with aplastic anemia who developed myelodysplastic syndrome and acute myeloid leukemia showing acquired hemoglobin H and increased fetal hemoglobin.
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During the first year of life, the growth process is highly vulnerable to several impairing factors that need to be understood. ⋯ Socioeconomic conditions, clinical/obstetric events and newborn diseases during the hospital stay had repercussions on these children's progress during their first year of life. Their growth profile was found to be very far from the reference standard, thus indicating a need for constant, differentiated assessment.
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p53, c-erbB-2 and epidermal growth factor receptor (EGFR) are cancer-related proteins that are usually expressed in head and neck squamous cell carcinoma (SCC). Their prognostic value remains controversial. ⋯ Further prospective studies should be conducted to confirm the influence of p53, c-erbB-2 and EGFR on histoclinical data and prognosis.
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In São Paulo, pneumonia is the main infectious cause of death among children. Parapneumonic pleural effusion is a possible complication and has to be treated surgically when the patient does not respond to antibiotics. ⋯ The bacteriological profile in our series of complicated pneumonia cases was similar to what has been described for non-complicated pneumonia cases. Future studies will be necessary to determine why these children presented a worse outcome.