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Giouleme O, Paschos P, Katsoula A, Panteliadou K, Vakalopoulou S, Garipidou V. Hepatitis C infection in a Greek population with inherited bleeding disorders. Haemophilia 2018; 24:e74-e76. [DOI: 10.1111/hae.13427] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 01/01/2023]
Affiliation(s)
- O. Giouleme
- Gastroenterology and Hepatology Division of the Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
| | - P. Paschos
- Gastroenterology and Hepatology Division of the Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
| | - A. Katsoula
- Gastroenterology and Hepatology Division of the Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
| | - K. Panteliadou
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
| | - S. Vakalopoulou
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
| | - V. Garipidou
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki Greece
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Anagnostis P, Vakalopoulou S, Christoulas D, Paschou SA, Papatheodorou A, Garipidou V, Kokkoris P, Terpos E. The role of sclerostin/dickkopf-1 and receptor activator of nuclear factor kB ligand/osteoprotegerin signalling pathways in the development of osteoporosis in patients with haemophilia A and B: A cross-sectional study. Haemophilia 2017; 24:316-322. [PMID: 29194852 DOI: 10.1111/hae.13384] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 12/19/2022]
Abstract
AIM Haemophilia A and B are associated with reduced bone mineral density (BMD). The aim of this study was to assess circulating sclerostin and dickkopf-1 (Dkk-1), (inhibitors of osteoblastic differentiation), as well as the receptor activator of nuclear factor kB ligand (RANKL)/osteoprotegerin (OPG) system (the major regulator of osteoclastogenesis), in patients with haemophilia (PWH), their possible correlations with clinical risk factors and the effect of ibandronate on these markers. METHODS Eighty-nine male PWH (mean age 45.9 ± 15.3 years) and 30 age-matched healthy male controls participated. BMD was assessed by DXA. Sclerostin, Dkk-1, RANKL and OPG were measured in serum of patients, controls, as well as in ten patients receiving oral ibandronate (150 mg/mo), at baseline and after 12 months. RESULTS Patients with haemophilia had lower circulating sclerostin (median ± IQR: 47.4 ± 26.93 vs 250 ± 250 pmol/L, P < .001), Dkk-1 (21.24 ± 17.18 vs 26.16 ± 15.32pg/mL, P = .04) and higher levels of RANKL (0.23 ± 0.03 vs 0.04 ± 0.03 pmol/L, P = .001), RANKL/OPG ratio (0.063 ± 0.25 vs 0.005 ± 0.11, P = .001) compared with controls. Patients with low BMD had higher OPG concentrations compared to those with normal BMD. Sclerostin and RANKL/OPG correlated positively with BMD. Patients with severe haemophilia had lower sclerostin concentrations compared with those with mild or moderate disease. The degree of arthropathy negatively correlated with sclerostin and Dkk-1 levels. PWH who received ibandronate showed a decrease in serum Dkk-1 without any significant effect on sclerostin and RANKL/OPG. CONCLUSIONS Patients with haemophilia present increased osteoclastic activity coupled with compensatory increased osteoblastic activity. Ibandronate did not affect RANKL/OPG ratio, but it decreased Dkk-1.
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Affiliation(s)
- P Anagnostis
- Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Vakalopoulou
- Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Christoulas
- Department of Haematology, 251 General Air Force Hospital, Athens, Greece
| | - S A Paschou
- Division of Endocrinology and Diabetes, "Aghia Sophia" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Papatheodorou
- Department of Haematology, 251 General Air Force Hospital, Athens, Greece
| | - V Garipidou
- Haemophilia Centre of Northern Greece, 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Kokkoris
- Department of Endocrinology, 251 General Air Force Hospital, Athens, Greece
| | - E Terpos
- Department of Clinical Therapeutics, School of Medicine, Alexandra General Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Abstract
The combination of acute leukemia and pregnancy is infrequent. It is estimated to occur in less than 1 in 75,000 pregnancies. Maternal and fetal outcomes have improved substantially in recent years. In general, multi-agent chemotherapy is given as soon as the diagnosis of leukemia is established, even if it is in the first trimester. There are two important considerations in the management of a patient with leukemia during pregnancy, the mother who needs optimal cancer therapy and the developing fetus who could potentially be affected by the disease and/or the teratogenicity of antineoplactic agents. Vaginal delivery is preferable, and caesarian section is reserved for obstetrical indications only.
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Affiliation(s)
| | | | | | | | - V. Garipidou
- 2nd Internal Medicine Department Hippokratio General Hospital, Thessaloniki, Greece
| | - S. Vakalopoulou
- 2nd Internal Medicine Department Hippokratio General Hospital, Thessaloniki, Greece
| | - H. Zaboulis
- 2nd Internal Medicine Department Hippokratio General Hospital, Thessaloniki, Greece
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Xochelli A, Kapoukranidou D, Kritsepi-Konstantinou M, Garipidou V, Albani M. Glutamate Agonists May Affect the Hematological Profile in Healthy Rats. ACTA ACUST UNITED AC 2015. [DOI: 10.9734/bjmmr/2015/17683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Paschou SA, Anagnostis P, Karras S, Annweiler C, Vakalopoulou S, Garipidou V, Goulis DG. Bone mineral density in men and children with haemophilia A and B: a systematic review and meta-analysis. Osteoporos Int 2014; 25:2399-407. [PMID: 25001982 DOI: 10.1007/s00198-014-2773-7] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 06/10/2014] [Indexed: 11/28/2022]
Abstract
SUMMARY Although haemophilia is not considered among the classic causes of secondary osteoporosis, the present meta-analysis provides strong evidence that men with haemophilia have a significant reduction in both lumbar spine and femoral bone mineral density, which appears to begin in childhood. INTRODUCTION Haemophilia is not considered among the classic causes of secondary osteoporosis. The aim of this study was to systematically review the literature for case-control trials that have studied bone mass in males with haemophilia and to meta-analyze the best evidence available. METHODS Electronic databases MEDLINE, EMBASE and CENTRAL were systematically searched for case-control trials that have studied bone mass in men or boys with haemophilia. Standardized mean difference (SMD) for bone mineral density (BMD) in the lumbar spine was the main study outcome and SMD in femoral neck and total hip BMD the secondary ones. Patient and control characteristics, such as age, body mass index (BMI), level of physical activity and blood-borne infections were recorded as possible predictors of the main outcome. RESULTS Thirteen studies were included in the systematic review and ten in the main outcome meta-analysis. Men with haemophilia demonstrated reduced lumbar spine [random effects SMD [95 % confidence interval (CI)] = -0.56 (-0.84, -0.28), between-study heterogeneity (I (2)) = 51 %] and femoral neck BMD [random effects SMD (95 % CI) = -0.82 (-1.21, -0.44), I (2) = 63 %] compared with controls, which indicated a large and clinically significant association. Similar results were obtained for children [random effects SMD (95 % CI) = -0.92 (-1.77, -0.07), I (2) = 92 %]. No evidence of publication bias was detected. There was no evidence that age, BMI, level of physical activity or presence of blood-borne infections predicted lumbar spine BMD. CONCLUSIONS This meta-analysis shows that men with haemophilia present a significant reduction in both lumbar spine and hip BMD, which appears to begin in childhood.
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Affiliation(s)
- S A Paschou
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki Medical School, "Papageorgiou" General Hospital, Ring Road, 56403, Nea Efkarpia, Thessaloniki, Greece
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Anagnostis P, Vakalopoulou S, Karras S, Charizopoulou M, Garipidou V. The role of arthropathy in the development of osteoporosis in patients with haemophilia: do we need more? Haemophilia 2013; 20:e83-5. [PMID: 24165289 DOI: 10.1111/hae.12284] [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] [Accepted: 09/20/2013] [Indexed: 11/29/2022]
Affiliation(s)
- P Anagnostis
- Haemophilia Centre of Northern Greece, Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Anagnostis P, Vakalopoulou S, Vyzantiadis TA, Charizopoulou M, Karras S, Goulis DG, Karagiannis A, Gerou S, Garipidou V. The clinical utility of bone turnover markers in the evaluation of bone disease in patients with haemophilia A and B. Haemophilia 2013; 20:268-75. [PMID: 24118364 DOI: 10.1111/hae.12271] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2013] [Indexed: 01/01/2023]
Abstract
Haemophilia A and B have been associated with increased prevalence of low bone mineral density (BMD). However, the utility of bone turnover markers (BTM) remains unknown. The aim of this study was to evaluate bone metabolism in men with haemophilia and to investigate associations between BTM and bone disease. Serum N- (NTX-I), C-terminal telopeptide of type I collagen (CTX-I) and tartrate-resistant acid phosphatase band-5b (TRAP-5b), as bone resorption markers, and osteocalcin (OC) and bone-specific alkaline phosphatase (b-ALP), as bone formation markers, were assessed. Seventy men with haemophilia A (n = 59) or B (n = 11) were studied. Patients with low BMD had significantly higher b-ALP concentrations compared with those with normal BMD (12.8 ± 1.60 vs. 9.72 ± 0.58 μg/L, P = 0.009), without any differences in the other BTM. NTX-I and CTX-I concentrations were negatively associated with oestradiol levels and hip BMD and positively with human immunodeficiency virus infection, number of affected joints and arthropathy scores. B-ALP and OC concentrations were negatively associated with hip BMD, severity of haemophilia and fracture history, and positively with the number of affected joints and testosterone concentrations. After multivariate analysis, NTX-I levels remained negatively associated with oestradiol levels, whereas b-ALP concentrations negatively correlated with the level of physical activity and positively with the number of affected joints. Increased bone metabolism exists in men with haemophilia and low BMD. Increased b-ALP levels may identify patients at high risk for fracture. Increased number of target joints, low physical activity and low oestradiol concentrations are independently associated with increased bone metabolism.
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Affiliation(s)
- P Anagnostis
- Haemophilia Centre of Northern Greece, Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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Anagnostis P, Vakalopoulou S, Charizopoulou M, Karras S, Garipidou V. Vitamin D deficiency in patients with haemophilia: an underestimated commorbidity. Haemophilia 2013; 19:e308-10. [DOI: 10.1111/hae.12187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2013] [Indexed: 12/28/2022]
Affiliation(s)
- P. Anagnostis
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki; Greece
| | - S. Vakalopoulou
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki; Greece
| | - M. Charizopoulou
- Department of Psychology; School of Philosophy; Aristotle University; Thessaloniki; Greece
| | - S. Karras
- Department of Endocrinology and Metabolism; Agios Pavlos General Hospital; Thessaloniki; Greece
| | - V. Garipidou
- Haemophilia Centre of Northern Greece; Second Propedeutic Department of Internal Medicine; Medical School; Aristotle University of Thessaloniki; Hippokration Hospital; Thessaloniki; Greece
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Lefkou E, Vakalopoulou S, Fragakis N, Karamanos D, Mamopoulos A, Kleta D, Perifanis B, Garipidou V. P.69 Venous thromboembolism in women; One year experience from a thrombophilia clinic. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70124-4] [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: 10/18/2022]
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Lefkou E, Mamopoulos A, Vakalopoulou S, Perifanis B, Aggelidou S, Theodoridou S, Moka E, Garipidou V. P.71 Recurrent miscarriage and gestational vascular complications; one year experience from a haematology-obstetric joint clinic. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70126-8] [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: 10/18/2022]
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Lefkou E, Vakalopoulou S, Mamopoulos A, Fragakis N, Perifanis V, Moka E, Katsarou Z, Garipidou V. P.70 Antiphospholipid syndrome in Eve; Clinical observations, phenotypes and correlations. Thromb Res 2011. [DOI: 10.1016/s0049-3848(11)70125-6] [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: 11/15/2022]
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Papadopoulou EC, Batzios SP, Dimitriadou M, Perifanis V, Garipidou V. Multiple myeloma and bone disease: pathogenesis and current therapeutic approaches. Hippokratia 2010; 14:76-81. [PMID: 20596260 PMCID: PMC2895290] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Multiple myeloma is a haematologic malignancy caused by clonal expansion of malignant plasma cells and associated with bone disease and hypercalcaemia. Myeloma cells are in close proximity to sites of active bone resorption and the interactions between those cells, osteoblasts and osteoclasts, are crucial not only for the bone distraction but for the proliferation of bone marrow cells as well. Recent studies have revealed that numerous regulating factors of osteoblast and osteoclast activity interfere with the pathogenesis of multiple myeloma's bone disease and that the understanding of the pathophysiological pathways involved is the first step towards discovering novel potential therapeutic approaches.
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Affiliation(s)
- E C Papadopoulou
- Haematology Section, 2 Propedeutic, Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokratio General Hospital, Thessaloniki, Greece
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E L, Fragakis N, Ioannidou E, Bounda A, Theodoridou S, Klonizakis P, Garipidou V. Increased levels of proinflammatory cytokines in children with family history of coronary artery disease. Clin Cardiol 2010; 33:E6-10. [PMID: 20229495 DOI: 10.1002/clc.20434] [Citation(s) in RCA: 5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Parental history of coronary artery disease (CAD) is considered an important risk factor for early atherosclerosis HYPOTHESIS The onset of the inflammatory process of atherosclerosis initiates early during childhood in children with positive family history (PFH) of CAD. METHODS We studied 55 healthy children (5-15 years), 30 (16 male) with PFH and 25 age and sex matched control subjects. Blood samples were taken to measure white blood count (WBC), glucose, total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), erythrocyte sedimentation rate (SDE), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-a). We performed cultures on monocytes (from peripheral blood) measuring in the cell culture supernatants the proinflammatory cytokines IL-6 and TNF-a, by using the immunoassay ELISA method. RESULTS : Higher values of body mass index (BMI), total cholesterol, LDL, cholesterol, TG, SDE, leucocytes, and CRP were calculated in children with PFH. Significantly higher values of cytokines in monocell cultures were measured in the PFH group compared to the control group (IL-6 = 139.32 +/- 80.84 pg/ml versus 14.30 +/- 12.97 pg/ml, p < 0.001 and TNF-a = 39.91 +/- 11.80 pg/ml versus 8.65 +/- 4.35 pg/ml, p < 0.001). IL-6 values in plasma and cultures were found independently associated with PFH of premature CAD (p < 0.001, p = 0.005, respectively). A similar relation was found for TNF-a values measured in cultures (p = 0.005) and CRP values in plasma (p < 0.001). The values of IL-6 were found proportionally related to TG. CONCLUSION In individuals with PFH of CAD the inflammatory process of atheromatosis appears to begin early in childhood. Except for triglycerides, this inflammatory process appears to occur independently of several traditional cardiovascular risk factors.
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Affiliation(s)
- Lefkou E
- Hippokrateion University Hospital of Thessaloniki, Greece.
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Mamopoulos A, Vakalopoulou S, Fileli A, Vosnakis C, Lefkou E, Garipidou V, Karagiannis V. P11 Congenital factor X deficiency and pregnancy: a case report. Thromb Res 2009. [DOI: 10.1016/s0049-3848(09)70056-8] [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: 11/26/2022]
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Hill M, Hanley J, Maclean R, Garipidou V, Tait R, Dolan G. GENETIC ANALYSIS IN HYPOFIBRINOGENEMIA IN ELEVEN FAMILIES. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02131.x] [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: 11/30/2022]
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Vakalopoulou S, Rizopoulou D, Zafiriadou E, Perifanis V, Tziomalos K, Lefkou E, Hill M, Dolan G, Garipidou V. Management of acute bleeding in a patient with congenital afibrinogenaemia. Haemophilia 2006; 12:676-8. [PMID: 17083521 DOI: 10.1111/j.1365-2516.2006.01340.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Congenital afibrinogenaemia is a rare bleeding disorder characterized by absence of fibrinogen and varying bleeding tendency. Treatment with fibrinogen concentrates is considered to be the best choice for afibrinogenaemic patients who experience bleeding. We report the case of a 22-year-old Greek patient who presented with large muscular haematomas and was treated with fibrinogen concentrates. The efficacy of this treatment and the problems that arose during his hospitalization are being discussed.
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Affiliation(s)
- S Vakalopoulou
- Haematology Section of Second Propedeutic, Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece.
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Garipidou V, Vakalopoulou S, Zafiriadou E, Kaloutsi V, Tziomalos K, Perifanis V. Uncommon manifestation of bleomycin-induced pulmonary toxicity in a patient with Hodgkin's disease. Ann Oncol 2005; 16:514-5. [PMID: 15668264 DOI: 10.1093/annonc/mdi073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Krikis N, Tziomalos K, Perifanis V, Vakalopoulou S, Karagiannis A, Garipidou V, Harsoulis F. Treatment of recurrent gastrointestinal haemorrhage in a patient with von Willebrand's disease with octreotide LAR and propranolol. Gut 2005; 54:171-2. [PMID: 15591529 PMCID: PMC1774363 DOI: 10.1136/gut.2004.049031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
Hemophagocytic syndrome (HPS) is an uncommon reactive disorder characterized by proliferation of histiocytes that actively engulf other hematopoietic cells causing cytopenia. It complicates several diseases including hematological neoplasias. We report the case of a 54-year-old woman who was admitted to our hospital with fever of unknown origin. Her clinical picture was characterized by renal failure, splenomegaly and pancytopenia. Findings on bone marrow examination showed HPS associated with multiple myeloma. A review of the literature revealed that only one case has previously been published.
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Garipidou V, Tsatalas C, Sinacos Z. Severe neutropenia in a patient with large granular lymphocytosis: prolonged successful control with cyclosporin A. Haematologica 1991; 76:424-5. [PMID: 1806448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A case of severe neutropenia associated with large granular lymphocytosis in a 40-year-old female is described. The patient, with no findings of an underlying systemic disorder, had suffered from recurrent life threatening, mainly pseudomonal, infections for about two years, despite the various regimes tried. During the last twelve months cyclosporin A treatment resulted in a significant increase in absolute neutrophil counts, concomitant with a remarkable decrease in bone marrow infiltration by GLs and almost normal counts of GLs in the peripheral blood. During this time she has remained completely free from infectious episodes. The mechanisms involved remain to be determined.
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Affiliation(s)
- V Garipidou
- B' Propedeutic clinic of Internal Medicine, Aristotelion University of Thessaloniki, Ippokration General Hospital, Greece
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Garipidou V, Secker-Walker LM. The use of fluorodeoxyuridine synchronization for cytogenetic investigation of acute lymphoblastic leukemia. Cancer Genet Cytogenet 1991; 52:107-11. [PMID: 1826229 DOI: 10.1016/0165-4608(91)90060-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The role of fluorodeoxyuridine (FUdR) synchronization in cytogenetic analysis of acute lymphoblastic leukemia (ALL) was investigated using samples of bone marrow (BM) (10 patients) and peripheral blood (PB) (2 patients), prepared for chromosome analysis using both 24-hour unstimulated cultures (24-hr) and cultures synchronized with FUdR. The mitotic index (MI) in FUdR was lower than in 24-hr in 8 of 10 BM and 2 of 2 PB cultures. The quality of the metaphases was the same in both cultures. The FUdR had a lower percentage of abnormal cells than the 24-hr in the 7 BM samples with a normal/abnormal population and sufficient analyzable cells in each culture for comparison (p less than 0.05). PB FUdR cultures yielded only normal cells. We conclude that FUdR cultures are inferior to 24-hr cultures for chromosome analysis in ALL.
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Affiliation(s)
- V Garipidou
- Department of Haematology, Royal Free Hospital and School of Medicine, London, U.K
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22
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Garipidou V, Yamada T, Prentice HG, Secker-Walker LM. Trisomy 8 in acute lymphoblastic leukemia (ALL): a case report and update of the literature. Leukemia 1990; 4:717-9. [PMID: 2214875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A case of acute lymphoblastic leukemia (ALL) cytogenetically characterized by trisomy 8 as a sole aberration is described. The patient, one of 116 adults with ALL investigated cytogenetically, was a 36-year-old male with leukocyte count 12.3 x 10(9)/liter with 90% blasts of FAB type L1 and common ALL immunological phenotype. Remission was achieved with the current U.K. treatment trial. The patient recovered from an autologous bone marrow transplant (BMT) in first remission but relapsed 15 months later. BMT, in second remission, from an unrelated donor, was rejected. Autologous reinfusion failed and he died 26 months after diagnosis. Molecular investigation of immunoglobulin gene rearrangement identified the same B cell clone at diagnosis and in relapse. The clinical and cytogenetic findings of six published cases of ALL with trisomy 8 have been reviewed with updates supplied by the authors. These reveal an heterogeneous group of patients ranging in age from 9 months to 39 years with no apparent association with a particular immunophenotype. Four patients were alive after 10-108 months follow-up. Two patients died, in relapse, 7 and 17 months after diagnosis. Thus trisomy 8 occurs in ALL with an incidence of 1-2%. The prognostic significance of this remains to be determined.
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Affiliation(s)
- V Garipidou
- Department of Haematology, Royal Free Hospital and School of Medicine, London, U.K
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