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Banic M, Pavlisa G, Hecimovic A, Grzelja J, Anic B, Samarzija M, Jankovic Makek M. Refractory systemic lupus erythematosus with chylous effusion successfully treated with sirolimus: a case report and literature review. Rheumatol Int 2023; 43:1743-1749. [PMID: 37326666 DOI: 10.1007/s00296-023-05363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
Chylous effusion is a rare manifestation of systemic lupus erythematosus (SLE). When it does occur in SLE, it is generally well treated with standard pharmacologic or surgical measures. We present a decade of management in a case of SLE with lung affliction and development of refractory bilateral chylous effusion and pulmonary arterial hypertension (PAH). In the first years, the patient was treated under a Sjogren syndrome diagnose. After few years, her respiratory condition worsened due to chylous effusion and PAH. Immunosuppression therapy (methylprednisolone) was reintroduced, and vasodilator therapy commenced. With this, her cardiac function remained stable, but respiratory function continuously worsened despite several therapy trials with different combinations of immunosuppressant (glucocorticoids, resochin, cyclophosphamide and mycophenolate mofetil). On top of pleural effusion worsening, the patient developed ascites and severe hypoalbuminaemia. Even though albumin loss was stabilized with monthly octreotide applications, the patient remained respiratory insufficient and in need of continuous oxygen therapy. At that point, we decided to introduce sirolimus on top of glucocorticoids and mycophenolate mofetil therapy. Her clinical status, radiological finding, and lung function gradually improved and she became respiratory sufficient at rest. The patient remains in our follow-up and has been stable on given therapy for over 3 years despite overcoming a severe COVID-19 pneumonia in 2021. This case adds to the body of evidence of sirolimus effectiveness in patients with refractory systemic lupus and is, to our best knowledge, the first case to report its successful application in a patient with SLE and refractory chylous effusion.
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Affiliation(s)
- M Banic
- Department of Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia
| | - G Pavlisa
- Department of Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia
| | - A Hecimovic
- Department of Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Salata 2, 10000, Zagreb, Croatia
| | - J Grzelja
- Department of Diagnostic and Interventional Radiology, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - B Anic
- Division of Clinical Immunology and Rheumatology, Department of Internal Medicine, University Hospital Centre Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Salata 2, 10000, Zagreb, Croatia
| | - M Samarzija
- Department of Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia
- School of Medicine, University of Zagreb, Salata 2, 10000, Zagreb, Croatia
| | - M Jankovic Makek
- Department of Lung Diseases Jordanovac, University Hospital Centre Zagreb, Jordanovac 104, 10000, Zagreb, Croatia.
- School of Medicine, University of Zagreb, Salata 2, 10000, Zagreb, Croatia.
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Hecimovic A, Kiefer C, Meindl A, Antunes R, Fantz U. Fast gas quenching of microwave plasma effluent for enhanced CO2 conversion. J CO2 UTIL 2023. [DOI: 10.1016/j.jcou.2023.102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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3
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Miravitlles M, Turner AM, Torres-Duran M, Tanash H, Rodríguez-García C, López-Campos JL, Chlumsky J, Guimaraes C, Rodríguez-Hermosa JL, Corsico A, Martinez-González C, Hernández-Pérez JM, Bustamante A, Parr DG, Casas-Maldonado F, Hecimovic A, Janssens W, Lara B, Barrecheguren M, González C, Stolk J, Esquinas C, Clarenbach CF. Characteristics of individuals with alpha-1 antitrypsin deficiency from Northern and Southern European countries: EARCO international registry. Eur Respir J 2023; 61:13993003.01949-2022. [PMID: 36997232 DOI: 10.1183/13993003.01949-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/10/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Alice M Turner
- Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - María Torres-Duran
- Servicio de Neumología, Hospital Álvaro Cunqueiro, NeumoVigo I+i Research Group, IIS Galicia Sur, Vigo, Spain
| | - Hanan Tanash
- Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Carlota Rodríguez-García
- Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - José Luis López-Campos
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain
| | - Jan Chlumsky
- Department of Pneumology, Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Catarina Guimaraes
- Pulmonology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Juan Luis Rodríguez-Hermosa
- Servicio de Neumología, Hospital Clínico de San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
- Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Angelo Corsico
- Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Cristina Martinez-González
- Pneumology Department, Hospital Universitario Central de Asturias, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José María Hernández-Pérez
- Pneumology Department, Hospital Universitario Nuestra Señora de La Candelaria, Santa Cruz de Tenerife, Spain
| | - Ana Bustamante
- Pneumology Section, Hospital Sierrallana-TresMares, Cantabria, Spain
| | - David G Parr
- Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Coventry, UK
| | - Francisco Casas-Maldonado
- Servicio de Neumología, Hospital Clínico Universitario San Cecilio, Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Ana Hecimovic
- University Hospital Center Zagreb, Clinic for Respiratory Diseases, Zagreb, Croatia
- University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Wim Janssens
- Katholieke Universiteit (KU) Leuven, Laboratory of Respiratory Diseases, Department of Chronic Disease, Metabolism and Ageing, Leuven, Belgium
- University Hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium
| | - Beatriz Lara
- Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Coventry, UK
| | - Miriam Barrecheguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Cruz González
- Servicio de Neumología, Hospital Clínico Universitario, Instituto de Investigación INCLIVA, Valencia, Spain
| | - Jan Stolk
- Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cristina Esquinas
- Pneumology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
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Miravitlles M, Turner AM, Torres-Duran M, Tanash H, Rodríguez-García C, López-Campos JL, Chlumsky J, Guimaraes C, Rodríguez-Hermosa JL, Corsico A, Martinez-González C, Hernández-Pérez JM, Bustamante A, Parr DG, Casas-Maldonado F, Hecimovic A, Janssens W, Lara B, Barrecheguren M, González C, Stolk J, Esquinas C, Clarenbach CF. Correction: Clinical and functional characteristics of individuals with alpha-1 antitrypsin deficiency: EARCO international registry. Respir Res 2023; 24:57. [PMID: 36800958 PMCID: PMC9938555 DOI: 10.1186/s12931-023-02340-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital Universitari Vall d'Hebron; Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
| | - Alice M. Turner
- grid.412563.70000 0004 0376 6589Respiratory Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK ,grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - María Torres-Duran
- grid.411855.c0000 0004 1757 0405Servicio de Neumología. Hospital Álvaro Cunqueiro. NeumoVigo I+I Research Group, IIS Galicia Sur, Vigo, Spain
| | - Hanan Tanash
- grid.4514.40000 0001 0930 2361Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Carlota Rodríguez-García
- grid.11794.3a0000000109410645Servicio de Neumología, Complejo Hospitalario Clínico-Universitario de Santiago, Santiago de Compostela, Spain
| | - José Luis López-Campos
- grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411109.c0000 0000 9542 1158Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Sevilla, Spain
| | - Jan Chlumsky
- grid.4491.80000 0004 1937 116XDepartment of Pneumology, Thomayer Hospital, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Catarina Guimaraes
- grid.465290.cPulmonology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
| | - Juan Luis Rodríguez-Hermosa
- grid.4795.f0000 0001 2157 7667Servicio de Neumología. Hospital Clínico de San Carlos. Departamento de Medicina, Facultad de Medicina,, Universidad Complutense de Madrid, Madrid, Spain ,grid.411068.a0000 0001 0671 5785Research Institute of Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Angelo Corsico
- grid.419425.f0000 0004 1760 3027Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy ,grid.8982.b0000 0004 1762 5736Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Cristina Martinez-González
- grid.411052.30000 0001 2176 9028Pneumology Department, Hospital Universitario Central de Asturias, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain
| | - José María Hernández-Pérez
- grid.411331.50000 0004 1771 1220Pneumology Department, Hospital Universitario Nuestra Señora de La Candelaria, Santa Cruz de Tenerife, Spain
| | - Ana Bustamante
- grid.413444.20000 0004 1763 6195Pneumology Section, Hospital Sierrallana-TresMares, Cantabria, Spain
| | - David G. Parr
- grid.412570.50000 0004 0400 5079Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK
| | - Francisco Casas-Maldonado
- grid.4489.10000000121678994Servicio de Neumología. Hospital Clínico Universitario San Cecilio. Departamento de Medicina, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Ana Hecimovic
- grid.412688.10000 0004 0397 9648Clinic for Respiratory Diseases, University Hospital Center Zagreb, Zagreb, Croatia ,grid.4808.40000 0001 0657 4636School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Wim Janssens
- grid.5596.f0000 0001 0668 7884Laboratory of Respiratory Diseases, Department of Chronic Disease, Metabolism and Ageing, Katholieke Universiteit (KU) Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Department of Respiratory Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Beatriz Lara
- grid.412570.50000 0004 0400 5079Department of Respiratory Medicine, University Hospitals of Coventry and Warwickshire, Clifford Bridge Road, Coventry, UK
| | - Miriam Barrecheguren
- grid.411083.f0000 0001 0675 8654Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Cruz González
- grid.411308.fServicio de Neumología, Hospital Clínico Universitario de Valencia. Instituto de Investigación INCLIVA, Valencia, Spain
| | - Jan Stolk
- grid.10419.3d0000000089452978Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cristina Esquinas
- grid.411083.f0000 0001 0675 8654Pneumology Department, Hospital Universitari Vall d’Hebron; Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - Christian F. Clarenbach
- grid.412004.30000 0004 0478 9977Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland
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Buchta C, Coucke W, Huf W, Griesmacher A, Müller MM, Mayr WR, Flesland Ø, Politis C, Wiersum-Osselton J, Aburto A, Badrick T, Bouacida L, Budina M, Duenas JA, Geilenkeuser WJ, Guimarães AVP, Hecimovic A, Jutzi M, Lee CK, Lim YA, Mammen J, Molnár PM, Mokhtari A, Morabito G, Muñiz-Diaz E, Niekerk T, Pakkanen A, Pezzati P, Popa R, Sárkány E, Siest JP, Suvagandha D, Thelen M, Ullhagen J, Vitkus D, Körmöczi GF. External quality assessment providers' services appear to more impact the immunohaematology performance of laboratories than national regulatory and economic conditions. Clin Chem Lab Med 2022; 60:361-369. [PMID: 35041777 DOI: 10.1515/cclm-2021-1219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/09/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Medical laboratories may, at their own discretion, exceed but not undercut regulatory quality requirements. Available economic resources, however, may drive or hinder eagerness to exceed minimum requirements. Depending on the respective scopes of regulatory and economic framework conditions, differing levels of quality efforts to safeguard laboratory performance can be anticipated. However, this has not yet been investigated. METHODS Immunohaematology external quality assessment (EQA) results collected by 26 EQA providers from their participant laboratories in 73 countries from 2004 to 2019 were evaluated. Error rates were aggregated in groups according to the respective national regulatory and economic framework conditions, to whether or not expert advice was provided in case of incorrect results, and the frequency of EQA samples. RESULTS These representative data indicate no association between national regulatory (mandatory participation in EQA, monitoring of performance of individual laboratories by authorities, financial consequences of incorrect results) and economic (level of national income, share of national health expenditure) conditions to the quality performance of medical laboratories in immunohaematology. However, EQA providers' support for laboratories in the event of incorrect results appear to be associated with lower error rates, but a high EQA sample frequency with higher error rates. CONCLUSIONS Further research into the impact of introducing or changing services of EQA providers is needed to confirm the results found in this first of its kind study.
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Affiliation(s)
- Christoph Buchta
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria
| | | | - Wolfgang Huf
- Karl Landsteiner Institute for Clinical Risk Management, Vienna, Austria
| | - Andrea Griesmacher
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria
| | - Mathias M Müller
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria
| | - Wolfgang R Mayr
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria.,Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
| | | | - Constantina Politis
- Coordinating Haemovigilance Centre and Surveillance of Transfusion (SKAEM) of the Hellenic National Public Health Organization, Marousi, Greece
| | - Johanna Wiersum-Osselton
- TRIP (Transfusion and Transplantation Reactions in Patients) Hemovigilance and Biovigilance Office, Leiden, The Netherlands
| | - Andrés Aburto
- Instituto de Salud Pública de Chile (ISPCH), Santiago, Chile
| | - Tony Badrick
- The Royal College of Pathologists of Australasia, Quality Assurance Programs (RCPAQAP), St. Leonards, Australia
| | | | | | - Joseph A Duenas
- American Association of Bioanalysts Proficiency Testing (AAB-PT), Houston, TX, USA
| | | | | | - Ana Hecimovic
- Croatian Institute for Transfusion Medicine (CITM), Zagreb, Croatia
| | - Markus Jutzi
- Interregionale Blutspende SRK AG, Ringversuchszentrum (RVZ SRK), Bern, Switzerland
| | - Chang-Keun Lee
- Institute for Quality Management in Healthcare (IQMH) Centre for Proficiency Testing, Toronto, Canada
| | - Young Ae Lim
- Korean Association of External Quality Assessment Service (KAEQAS), Seoul, Korea.,Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea
| | - Joy Mammen
- Christian Medical College Vellore (CMC Vellore), Vellore, Tamil Nadu, India
| | | | - Azita Mokhtari
- Bio-Rad Laboratories - External Quality Assurance Services (EQAS), Irvine, CA, USA
| | | | - Eduardo Muñiz-Diaz
- Immunohematology Department, Blood and Tissue Bank of Catalonia, External Quality Assessment on Immunohematology of the Spanish Society of Blood Transfusion (SETS), Barcelona, Spain
| | - Truscha Niekerk
- South African National Blood Service Proficiency Testing Scheme (SANBS PTS), Weltevreden Park, South Africa
| | | | | | - Razvan Popa
- Asociatia Pentru Calitate in Laboratoare (CALILAB), Bucharest, Romania
| | - Erika Sárkány
- QualiCont In vitro Diagnostic Quality Control Nonprofit Ltd., Szeged, Hungary
| | | | - Dhitiwass Suvagandha
- Division of Proficiency Testing, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Marc Thelen
- Dutch Foundation for Quality Assessment in Medical Laboratories (SKML), Nijmegen, Netherlands
| | | | - Dalius Vitkus
- Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Günther F Körmöczi
- Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), Vienna, Austria.,Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
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Kruhonja Galic Z, Jagnjic S, Bingulac-Popovic J, Planinc Peraica A, Hecimovic A, Strauss Patko M, Jukic I. Warm red blood cell autoantibodies and clinical diagnoses in patients with or without autoimmune hemolysis. Transfus Clin Biol 2019; 27:25-29. [PMID: 31708346 DOI: 10.1016/j.tracli.2019.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 10/17/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Red blood cell autoantibodies (RBC autoAbs) of IgG class are found in the majority of patients with warm autoimmune hemolytic anemia (wAIHA) but sometimes also during the pretransfusion testing of patients with different diagnoses but without hemolysis. The aim of the study was to identify the main differences between these two groups of patients according to age, gender, subclass and titer of IgG RBC autoAbs and diagnosis. MATERIAL AND METHODS In the 9-year retrospective study, data were collected from records of 291 patients with IgG RBC autoAbs detected by gel technique, from which 111 with wAIHA. RESULTS More than 85% of patients in both groups were over 40 years old, with male to female ratio 1:1.9 in wAIHA vs 1:1.3 in patients without hemolysis (P=0.0916). The main characteristics of patients with wAIHA vs patients without hemolysis were: IgG only 38% vs 70%, IgG+Complement 62% vs 30%, total IgG1 79% vs 55%, IgG1+IgG3 35% vs 11%, titer of 100 for IgG1+IgG3 17% vs 3% (P<0.0001), respectively, while titer of 100 for IgG1 18% vs 9% (P=0.0241). The underlying diagnosis in wAIHA vs patients without hemolysis: hematologic disorders 41% vs 22% (P=0.0006), autoimmune disorders 12% vs 13% (P=0.8033), solid tumors 5% vs 14% (P=0.0154) and surgery procedures 6% vs 26% (P<0.0001). CONCLUSION We observed more wAIHA patients with high titer of IgG1 and high prevalence of IgG1+IgG3 and consider that patients without hemolysis having identical results might be interesting to find out how they are protected from damage by RBC autoAbs.
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Affiliation(s)
- Z Kruhonja Galic
- Department of Immunohematology, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - S Jagnjic
- Department of Immunohematology, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - J Bingulac-Popovic
- Department of Molecular Diagnostics, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - A Planinc Peraica
- Department of Hematology, Clinical Hospital Merkur, Zajceva 19, 10000 Zagreb, Croatia; School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia.
| | - A Hecimovic
- Department of Reagents Production, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - M Strauss Patko
- Medical Department, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia.
| | - I Jukic
- Medical Department, Croatian Institute of Transfusion Medicine, Petrova 3, 10000 Zagreb, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Cara Hadrijana 10/E, 31000 Osijek, Croatia.
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Janković Makek M, Glodic G, Sabol I, Zmak L, Sola AM, Marusic A, Marekovic I, Hecimovic A, Vukic Dugac A, Dzubur F, Jakopovic M, Ticac B, Kardum Bulat L, Popovic Grle S, Barisic B, Carevic Vladic V, Strelec D, Pavlisa G, Samarzija M. Cure rates in nontuberculous mycobacterial pulmonary disease. Tuberculosis (Edinb) 2019. [DOI: 10.1183/13993003.congress-2019.pa4645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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8
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Hecimovic A, Jakopovic M, Vukic Dugac A, Dzubur F, Samarzija M. Metastatic cancer mimics interstitial lung disease. Cases when we need fast diagnosis and treatment. Monaldi Arch Chest Dis 2019; 89. [PMID: 31162486 DOI: 10.4081/monaldi.2019.1041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 05/14/2019] [Indexed: 11/22/2022] Open
Abstract
Interstitial lung diseases (ILD) are a heterogeneous group of diseases and one of the differential diagnosis which have to be excluded during diagnostic procedures are malignancies. We will present four patients who were referred to our Department because of suspicion of interstitial lung diseases according to radiology finding. In one case only, one of the radiologist's differential diagnosis was pulmonary lymphangitic carcinomatosis. All four patients had exertional dyspnea and dry cough which are nonspecific and can be first manifestation of ILD or obstructive lung diseases. After diagnostic evaluation in three cases, diagnosis was pulmonary lymphangitic carcinomatosis due to metastatic lung adenocarcinoma and in one due to metastatic adenocarcinoma of unknown primary origin. Patients with lymphangitic carcinomatosis have poor prognosis without treatment and usually die because of respiratory failure. With these four cases we want to highlight importance of thinking about malignancies when we have patients with suspicion of interstitial lung disease especially when reticular pattern is present on chest X ray. We also wanted to show how important is radiology finding and multidisciplinary approach, and how radiologist's differential diagnosis can be very helpful in making decisions in further investigations and way of clinicians thinking.
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Affiliation(s)
- Ana Hecimovic
- Department for Lung Diseases, University Hospital Centre Zagreb.
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9
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Hecimovic A, Vukic Dugac A, Jankovic Makek M, Cikes M, Samarzija M, Jakopovic M. Treatment of EGFR positive lung adenocarcinoma in a heart transplanted patient. Monaldi Arch Chest Dis 2019; 89. [PMID: 31315351 DOI: 10.4081/monaldi.2019.1023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/12/2019] [Indexed: 11/23/2022] Open
Abstract
Lung cancer incidence in heart transplant patients is higher than in general population and correlates with smoking history. EGFR-mutations are more frequent in adenocarcinoma and among non-smoking women but incidence in solid organ transplanted patients is still not known. We present case of a 65-year-old ex-smoker male with history of heart transplantation and EGFR positive metastatic lung adenocarcinoma. At admission he was in a severe clinical condition and treatment with erlotinib was started. Initially he had good clinical and radiologic response to treatment with only grade 1 side effects. Data about drug interactions between cyclosporine and erlotinib are insufficient but we have to take this interaction into consideration during treatment because both drugs are substrates and inhibitors of CYP34A. In our case erlotinib was safe and well tolerated drug, there were no relevant toxicity, but close monitoring and dose reduction of cyclosporine was needed.
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Affiliation(s)
- Ana Hecimovic
- Department for Lung Diseases, University Hospital Centre Zagreb.
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Jankovic M, Sabol I, Zmak L, Jakopovic M, Sola AM, Popovic-Grle S, Bulat-Kardum L, Ticac B, Vukic Dugac A, Hecimovic A, Dzubur F, Samarzija M, Carevic-Vladic V, Sekula D. Mycobacterium xenopi pulmonary disease in Croatia. Tuberculosis (Edinb) 2017. [DOI: 10.1183/1393003.congress-2017.pa2737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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Jankovic M, Sabol I, Zmak L, Sola AM, Bulat-Kardum L, Popovic Grle S, Ticac B, Jakopovic M, Vukic Dugac A, Hecimovic A, Dzubur F, Carevic-Vladic V, Samarzija M, Strelec D. 5-year survival of patients with nontuberculous mycobacteria pulmonary disease (NTM-PD)–data from Croatian national registry. Tuberculosis (Edinb) 2017. [DOI: 10.1183/1393003.congress-2017.pa2733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Jakopovic M, Bitar L, Cucevic B, Plestina S, Mazuranic I, Seiwerth S, Hecimovic A, Vukic Dugac A, Jankovic M, Redzepi G, Samarzija M. First experience with osimertinib in patients with T790M mutation previously treated with EGFR – TKIs in Croatia. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e20518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e20518 Background: EGFR T790M mutation is responsible for around 60% cases of resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) in patients who have lung cancer with an activating EGFR mutation. Methods: We administered osimertinib 80 mg once daily in 8 patients with advanced lung cancer who had radiologically documented disease progression after previous treatment with first and second-line EGFR tyrosine kinase inhibitors. Results: We treated 8 patients with osimertinib with stage IV lung adenocarcinoma. Four patients were males and four were females, median age 62 (raging from 54 to 82). Four patients were never smoker, and four were ex-smokers. All patients had initially deletion 19 in EGFR gene and then developed T790M mutation. In all patients T790M was proven from tumor tissue. Majority of patients were ECOG 1. All patients were previously treated with first or second line EGFR TKIs (erlotinib, gefitinib or afatinib) and had radiologically documented disease progression. Three patients were treated with osimertinib in third line setting, 2 in fourth, one in fifth, one in sixth and one even in tenth line setting. Median time to response was 4 weeks (raging from 3 to 7). All 8 patients had partial response (PR) with still no recorded disease progression. Duration of response is from 7 to 46 weeks and still ongoing. No significant side effects were observed. Conclusions: Osimertinib is highly active in patients with lung adenocarcinoma which harbor EGFR T790M mutation who had had disease progression during prior therapy with EGFR tyrosine kinase inhibitors. There were no serious side effects of treatment.
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Affiliation(s)
| | - Lela Bitar
- Univeristy Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | | | | | | | | | | | - Gzim Redzepi
- University Hospital Centre Zagreb, Zagreb, Croatia
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13
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Jakopovic M, Fedza D, Bitar L, Markelić I, Seiwerth F, Hecimovic A, Čučević B, Mazuranic I, Redzepi G, Dugic AV, Jankovic M, Samarzija M. P1.04-025 The Impact of Emergency Presentation on Survival of Lung Cancer Patients. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Vukic Dugac A, Hecimovic A, Jankoviç Makek M, Dzubur F, Seiwerth S, Samarzija M. Pathological fracture and osteolysis of the rib with pleural effusion - is this malignant? Neth J Med 2016; 74:369. [PMID: 27762227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- A Vukic Dugac
- Department for respiratory diseases, University Hospital Centre Zagreb, Zagreb, Croatia
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Jakopovic M, Bitar L, Markelic I, Seiwerth F, Dzubur F, Hecimovic A, Cucevic B, Mazuranic I, Redzepi G, Vukic Dugac A, Jankovic Makek M, Samarzija M. The effect of emergency presentation on survival of lung cancer patients. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.e18041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Lela Bitar
- Univeristy Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | - Fedza Dzubur
- University Hospital Centre Zagreb, Zagreb, Croatia
| | | | | | | | - Gzim Redzepi
- University Hospital Centre Zagreb, Zagreb, Croatia
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16
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Jankovic Makek M, Pavlisa G, Jakopovic M, Redzepi G, Zmak L, Vukic Dugac A, Hecimovic A, Mazuranic I, Jaksch P, Klepetko W, Samarzija M. Early onset of nontuberculous mycobacterial pulmonary disease contributes to the lethal outcome in lung transplant recipients: report of two cases and review of the literature. Transpl Infect Dis 2016; 18:112-9. [PMID: 26556693 DOI: 10.1111/tid.12481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 09/21/2015] [Accepted: 09/21/2015] [Indexed: 11/29/2022]
Abstract
Lung transplant (LuTx) recipients represent a population at risk of nontuberculous mycobacterial pulmonary disease (NTM-PD). Yet the risk factors, the timing of NTM-PD after transplantation, and the association with allograft dysfunction all remain poorly defined. We report 2 cases of early-onset NTM-PD and review the literature, focusing on NTM-PD in LuTx recipients not colonized with NTM prior to transplantation. In addition, we summarize the main characteristics and differences between early- and late-onset disease.
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Affiliation(s)
- M Jankovic Makek
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - G Pavlisa
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - M Jakopovic
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - G Redzepi
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
| | - L Zmak
- National Reference Laboratory for Mycobacteria, National Institute of Health, Zagreb, Croatia
| | - A Vukic Dugac
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
| | - A Hecimovic
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia
| | - I Mazuranic
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Thoracic Radiology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - P Jaksch
- Department of Surgery, Division of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - W Klepetko
- Department of Surgery, Division of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - M Samarzija
- Department for Lung Diseases, University Hospital Centre Zagreb, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Hecimovic A, Jakopovic M, Pavlisa G, Jankovic M, Vukic-Dugac A, Redzepi G, Brcic L, Samarzija M, Gupta N. SUCCESSFUL TREATMENT OF PULMONARY AND LYMPHATIC MANIFESTATIONS OF LYMPHANGIOLEIOMYOMATOSIS WITH SIROLIMUS. Lymphology 2015; 48:97-102. [PMID: 26714374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Lymphangioleiomyomatosis (LAM) is a rare, progressive, diffuse cystic lung disease predominantly affecting women of child bearing age. Recently treatment with sirolimus was shown to stabilize lung function decline and improve quality of life in patients with LAM. We treated three premenopausal women suffering from LAM manifesting as diffuse cystic lung disease, chylous effusions, and lymphangioleioyomas with sirolimus (1-3 mg a day; sirolimus trough levels 2.9-8.5 ng/ml). All three patients had a remarkable response to sirolimus, with resolution of effusions, improvement in lung function and shrinking of abdominal lymphangioleiomyomas. Our case series further complements the literature in that sirolimus is a safe and effective treatment for LAM and its lymphatic manifestations.
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