A 80-year-old man was admitted because of acute-onset thrombocytopenia and renal failure. He was diagnosed with Bence Jones (lambda) -type multiple myeloma associated with sepsis with ...methicillin-resistant Staphylococcus aureus. On admission, serum amylase activity was elevated to 1,814 IU/l (98% salivary type; S-amylase). Several days after admission, he developed bilateral myelomatous pleuritis. The activity of S-amylase in the effusion was 5,495 IU/l. Myeloma cells in the pleural effusion were positive for cytoplasmic amylase with an antibody against human amylase. High S-amylase activity was detected in the supernatant of cultured myeloma cells in the effusion. Furthermore, S-amylase gene expression was detected by RT-PCR. A diagnosis of amylase-producing multiple myeloma was made. The patient died of renal insufficiency complicated by severe DIC. We report a rare case of amylase-producing myeloma confirmed by immunocytochemistry, culture method, and gene expression.
A 60-year-old man with acute promyelocytic leukemia in complete remission had minimal residual disease (MRD). After two courses of arsenic trioxide treatment, the MRD disappeared. In October 2005, he ...received an unmanipulated autologous peripheral blood stem cell transplantation (autoPBSCT). Hematologic recovery was prompt; however, after day 21 following the autoPBSCT, platelet counts decreased to below 10 x 10(9)/l. A bone marrow aspirate showed an increased number of immature megakaryocytes, and platelet-associated IgG was elevated to 48.5 ng/10(7) platelets. A diagnosis of autoimmune thrombocytopenia was made. The combination of oral prednisolone (40 mg/day) and bolus immunoglobulin infusion (400 mg/kg, for 5 consecutive days) was ineffective. He was given azathioprine (50 mg/day, orally), and 10 days after the initiation of the treatment, the platelet counts gradually increased and recovered to over 50 x 10(9)/l on day 168, and 100 x 10(9)/l on day 364. To the best of our knowledge, successful treatment of ITP following auto PBSCT with azathioprine has not been previously reported.
Help-Seeking Perspectives for Counseling Practices Mizuno, Haruhisa; Iida, Toshiharu; Nagai, Satoru ...
The Proceedings of the Annual Convention of the Japanese Psychological Association,
2019/09/11
Journal Article
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