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

Related Links:

Authors: De Luca L, Laurenzana I, Trino S, Lamorte D, Caivano A, Musto P Abstract INTRODUCTION: Multiple myeloma (MM) is characterized by a clonal proliferation of neoplastic plasma cells (PCs) in bone marrow (BM) and the interplay between MM PCs and the BM microenvironment, which plays a relevant role in its pathogenesis. In this important cross-talk, extracellular vesicles (EVs) are active. EVs, including small and medium/large EVs, are lipid bi-layer particles released in circulation by normal and neoplastic cells. A selected cargo of lipids, proteins, and nucleic acids is loaded into EVs, and delivered locally ...
Source: Expert Review of Molecular Diagnostics - Category: Laboratory Medicine Tags: Expert Rev Mol Diagn Source Type: research
We describe the spontaneous appearance and persistence of NPM1-mutated-specific T cells, which may contribute to the maintenance of long-lasting remissions. Future studies are warranted to investigate the potential role of both autologous and allogeneic adoptive immunotherapy in NPM1-mutated AML patients. PMID: 30783516 [PubMed]
Source: Oncotarget - Category: Cancer & Oncology Tags: Oncotarget Source Type: research
Publication date: April 2019Source: Biomedicine &Pharmacotherapy, Volume 112Author(s): Jichun Ma, Dehong Wu, Jing Yi, Yunyun Yi, Xin Zhu, Hongchun Qiu, Rong Kong, Jiang Lin, Jun Qian, Zhaoqun DengAbstractDysregulation of miR-378 has been found in diverse types of tumors as well as in leukemia. The role of miR-378 in chronic myeloid leukemia (CML) remains unclear. The aim of the study was to reveal the potential effects of miR-378 in the pathological process and progress in CML. Our results showed general level of miR-378 was significant higher in CML patients compared to controls. Overexpression of miR-378 dramatically...
Source: Biomedicine and Pharmacotherapy - Category: Drugs & Pharmacology Source Type: research
ConclusionWe have shown a prevalence of 11.8% for AIC among our CLL patients. AIC was associated with unsatisfactory normalization of the hematological parameters even with therapy and lower number of patients with CLL downstaging in comparison with patients without AIC. These results suggest that AIC is a fingerprint of a biologically more aggressive disease even if no significant impact on overall survival was found.
Source: Hematology Oncology and Stem Cell Therapy - Category: Cancer & Oncology Source Type: research
Conditions:   Acute Lymphoblastic Leukemia (ALL);   Acute Myeloid Leukemia (AML);   Myelodysplastic Syndromes (MDS);   NK-Cell Leukemia;   Hodgkin Lymphoma;   Non Hodgkin Lymphoma (NHL);   Juvenile Myelomonocytic Leukemia (JMML);   Chronic Myeloid Leukemia (CML) Interventions:   Drug: Cyclophosphamide;   Biological: Fludarabine;   Drug: Thiotepa;   Drug: Melphalan;   Biological: G-csf;   Drug: Mesna;   Device: CliniMACS; ...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Relapsed Adult AML Interventions:   Drug: Gemtuzumab Ozogamicin;   Drug: Pracinostat Sponsor:   Medical College of Wisconsin Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: Available online 20 February 2019Source: Biocybernetics and Biomedical EngineeringAuthor(s): Roopa B. Hegde, Keerthana Prasad, Harishchandra Hebbar, Brij Mohan Kumar SinghAbstractAutomated classification and morphological analysis of white blood cells has been addressed since last four decades, but there is no optimal method which can be used as decision support system in laboratories due to biologically complex nature of the cells. Automated blood cell analysis facilitates quick and objective results and can also handle massive amount of data without compromising with efficiency. In the present study, we...
Source: Biocybernetics and Biomedical Engineering - Category: Biomedical Engineering Source Type: research
We present the case of a woman with 24 gestational weeks presenting fever, hepatosplenomegaly, pancytopenia, and inversion of albumin/globulin ratio. Anti-rK39 was positive and amastigotes were visualized on myelogram. Treatment with LAmB showed disease improvement. The newborn was born healthy at term, with delivery performed without complications. As VL in pregnancy can progress to death and complications for the mother-fetus binomial, inclusion of VL in the differential diagnosis of patients from endemic areas with compatible clinical picture is mandatory. Treatment with LAmB demonstrates safety and high cure rates in pregnancy.
Source: Revista da Sociedade Brasileira de Medicina Tropical - Category: Tropical Medicine Source Type: research
Authors: López Melero E, Ruíz-Roso G, Botella I, Ortego Pérez S, Delgado M, Fernández Lucas M PMID: 30782500 [PubMed - as supplied by publisher]
Source: Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia - Category: Urology & Nephrology Tags: Nefrologia Source Type: research
Authors: Santos MFM, Oliveira FCAC, Kishimoto RK, Borri D, Santos FPS, Campregher PV, Silveira PAA, Hamerschlak N, Mangueira CLP, Duarte FB, Crepaldi AH, Salvino MA, Velloso EDRP Abstract Cytogenetics is essential in myeloid neoplasms (MN) and pre-analytical variables are important for karyotyping. We assessed the relationship between pre-analytical variables (time from collection to sample processing, material type, sample cellularity, and diagnosis) and failures of karyotyping. Bone marrow (BM, n=352) and peripheral blood (PB, n=69) samples were analyzed from acute myeloid leukemia (n=113), myelodysplastic syndro...
Source: Brazilian Journal of Medical and Biological Research - Category: Research Tags: Braz J Med Biol Res 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