Myleidic Leukemia

Case 679 ________________________________________ CLINICAL HISTORY The patient is a 10 category old female, who underwent liver transplantation at the years of 2 for Alagille syndrome-related end-st get on liver disease. Prior to transplantation, she received 36 mg of thymoglobulin followed by 24 mg post transplant, and tacrolimus 2 mg twice daily. Her immediate post transplant course was conglomerate by a pulmonary thromboembolism and acute cellular rejection which were treat with corticosteroids and antibiotics. or so one year after transplant, the patient presented with flu-like symptoms that included fever, rhinorrhea, embody aches and an EBV titer of 30 million copies/ml. She was admitted for ganciclovir and CytoGam ecesis with EBV surveillance. An abdominal CT scan show a liver lesion along with cervical and axillary adenopathy. A liver biopsy demonstrated a liverwort Epstein-Barr virus-associated smooth muscle tumor. A lymph lymph node biopsy revealed a CD20 p eremptory infectious mononucleosis-like post transplant lymphoproliferative turnover (PTLD). Immunosuppression was suspended, and she was treated with ganciclovir, CMV-IGIV and rituximab. notwithstanding the reduction in immunosuppression, her liver lesions increase in surface. Chemotherapy was felt to be of no additional advantage in treating the CD20 prohibit liver lesion.

The liver lesions were monitored with scans She received 4 doses of rituximab with decrease in size of her lymph node PTLD. At the age of 8 she was no longer receiving immunosuppression and her liver masses remained unchanging in size by CT scan evaluation. At 10 age of age, she pre! sented to the hospital with abdominal pain. A subscriber line profile demonstrated the avocation: A bone marrow biopsy and take away were performed along with blend cytometry studies, cytogenetic and genotypic studies. PATHOLOGY The peripheral blood demonstrated a normochromic, normocytic anemia with a leukocytosis and myeloid leave shift with 1% blasts (Figure...If you want to get a broad essay, order it on our website: BestEssayCheap.com

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