Smear Campaign: Misattribution of Pancytopenia to a Tick-Borne Illness

We report the case of a 51-year-old woman presenting with a targetoid rash and pancytopenia after a tick bite. Initial evaluation was notable for severe neutropenia on the complete blood cell count differential, a positive Lyme IgM antibody, and a peripheral blood smear demonstrating atypical lymphocytes. While her pancytopenia was initially attributed to tick-borne illness, peripheral flow cytometry showed 7% myeloblasts, and a bone marrow biopsy confirmed 60% blasts. The patient was ultimately diagnosed with acute myelogenous leukemia, in addition to early, localized Lyme disease. This case highlights the differential diagnosis for pancytopenia, cytopenia patterns for different tick-borne illnesses, the risk of premature closure in internal medicine, and management of Lyme disease in hosts with altered immunity.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research

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Publication date: September 2019Source: Human Pathology: Case Reports, Volume 17Author(s): Nitya Prabhakaran, Katsiaryna Laziuk, Richard D. HammerAbstractThe World Health Organization (WHO) recognizes aggressive natural killer (NK)-cell leukemia and extranodal NK/T-cell lymphoma, nasal type as Epstein Barr Virus (EBV) associated lymphoproliferative disorders that may have overlapping features and must be distinguished from other T-cell lymphomas. A 35-year-old Hispanic female presented with fever of unknown origin, hemolysis and pancytopenia. Bone marrow biopsy with flow cytometry was negative for malignancy. Jejunal resec...
Source: Human Pathology: Case Reports - Category: Pathology Source Type: research
Publication date: Available online 18 May 2019Source: Journal of Biomedical InformaticsAuthor(s): Athina Tsanousa, Stavroula Ntoufa, Nikos Papakonstantinou, Kostas Stamatopoulos, Lefteris AngelisAbstractIn chronic lymphocytic leukemia (CLL) the interaction of leukemic cells with the microenvironment ultimately affects patient outcome. CLL cases can be divided in two subgroups with different clinical course based on the mutational status of the immunoglobulin heavy variable (IGHV) genes : mutated CLL (M-CLL) and unmutated CLL (U-CLL). Since in CLL, the differentiated relation of genes between the two subgroups is of greater...
Source: Journal of Biomedical Informatics - Category: Information Technology Source Type: research
Publication date: Available online 17 May 2019Source: The Lancet HaematologyAuthor(s): Jacob D Soumerai, Ai Ni, Mohamed Darif, Anil Londhe, Guan Xing, Yong Mun, Neil E Kay, Tait D Shanafelt, Kari G Rabe, John C Byrd, Asher A Chanan-Khan, Richard R Furman, Peter Hillmen, Jeffrey Jones, John F Seymour, Jeffrey P Sharman, Lucille Ferrante, Mehrdad Mobasher, Thomas Stark, Vijay ReddySummaryBackgroundClinically validated prognostic models for overall survival do not exist for patients with relapsed or refractory chronic lymphocytic leukaemia (CLL) who are on targeted therapies. We aimed to create a prognostic model to identify ...
Source: The Lancet Haematology - Category: Hematology Source Type: research
SERENA LIPSCOMB, now 23, was living in Essex with her mother Melanie and father Ian when she was diagnosed with acute lymphoblastic leukaemia.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Authors: Figoni J, Chirouze C, Hansmann Y, Lemogne C, Hentgen V, Saunier A, Bouiller K, Gehanno JF, Rabaud C, Perrot S, Caumes E, Eldin C, de Broucker T, Jaulhac B, Roblot F, Toubiana J, Sellal F, Vuillemet F, Sordet C, Fantin B, Lina G, Gocko X, Dieudonné M, Bodaghi B, Gangneux JP, Degeilh B, Partouche H, Lenormand C, Sotto A, Raffetin A, Monsuez JJ, Michel C, Boulanger N, Cathebras P, Tattevin P, endorsed by scientific societies Abstract Lyme borreliosis is transmitted en France by the tick Ixodes ricinus, endemic in metropolitan France. In the absence of vaccine licensed for use in humans, primary prevent...
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research
ConclusionsTP LBC is capable of detecting endocervical epithelial abnormalities and may be used as a substitute for ECC. Performing a CB did not lead to detection of additional abnormalities, although it complemented TP findings and facilitates the performance of ancillary studies.
Source: Journal of the American Society of Cytopathology - Category: Cytology Source Type: research
Publication date: Available online 16 April 2019Source: Ticks and Tick-borne DiseasesAuthor(s): Karla Dayane Gruhn, Maria Ogrzewalska, Tatiana Rozental, Itacir Olivio Farikoski, Carolina Blanco, Lucas de Souza Freitas, Elba Regina Sampaio de Lemos, Vânia Maria França RibeiroAbstractCapybaras (Hydrochoerus hydrochaeris Linnaeus, 1766) (Rodentia: Caviidae) are important hosts of Amblyomma ticks (Acari: Ixodidae), which in turn can transmit rickettsiae to humans and animals. However, there is a scarcity of studies about the tick fauna and rickettsial infection in the Amazon region. The present study evaluated ric...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research
Publication date: Available online 18 May 2019Source: Journal of Microbiology, Immunology and InfectionAuthor(s): Jun Yi Sim, Po-Ren Hsueh, Pei-Chien Chuang, Ping-Ing Lee
Source: Journal of Microbiology, Immunology and Infection - Category: Microbiology Source Type: research
This article describes clinical guidelines for the administration of moxetumomab pasudotox to patients with R/R HCL and presents related case studies. METHODS: A limited review of the literature on HCL was undertaken. FINDINGS: Nursing care of patients prescribed moxetumomab pasudotox includes monitoring clinical and laboratory parameters, managing side effects, being aware of signs of serious side effects, and maintaining patient hydration during administration. PMID: 31099793 [PubMed - in process]
Source: Clinical Journal of Oncology Nursing - Category: Nursing Authors: Tags: Clin J Oncol Nurs Source Type: research
ConclusionsB-cell neurolymphomatosis most commonly manifests as T2-weighted hyperintense, enhancing linear or fusiform neural enlargement associated with muscular denervation on MRI, with intense FDG activity on PET/CT. It is most often an isolated site of disease, presenting after progression or recurrence. A familiarity with the imaging appearance of neurolymphomatosis can help refine the differential diagnosis, direct biopsy, and aid in accurate diagnosis.
Source: Skeletal Radiology - Category: Radiology Source Type: research
More News: Acute Leukemia | Acute Myeloid Leukemia | Bone Marrow Aspiration and Biopsy | Internal Medicine | Leukemia | Lyme Disease | Pancytopenia | Papanicolaou (Pap) Smear | Tickborne Diseases