Now I made a mnemonic to remember this :D
Mnemonic: In hypERcortisolism, Eosinophils Reduce.
Why do corticosteroids cause eosionopenia? Why does hypocortisolism cause an increase in eosinophil count?
Hello
Women who have had breast biopsies in the recent past, that showed atypical hyperplasia, are at increased risk of breast cancer in the future. This is because of the changes in the breast that prompted the biopsies and not the biopsy itself, according to the Gail model of breast cancer risk assessment.
Moreover, high breast density (due to high fat diet and obesity) - individualised and as a modifiable risk factor itself, in combination with proliferative benign breast disease, increase the risk of cancer, but is relatively uncommon.
Source: http://jnci.oxfordjournals.org/content/105/14/1043.full.pdf
Thats all
- Jaskunwar Singh
Hey guys, there are multiple causes of acute kidney injury in a cancer patient, namely sepsis, metastasis, tumor lysis syndrome, etc. But there is another reason which we often overlook, which is drug-induced.
1. Thrombotic microangiopathy: Associated with agents targeting vascular endothelial growth factor(VEGF), eg., Ranibizumab, Bevacizumab. These drugs also block the angiogenesis in the glomerular vasculature, such that the injured endothelium isn't replaced, leading to multiple foci of platelet aggregations just like in TTP and HUS.
2. Focal segmental glomerulosclerosis: Associated with tyrosine kinase inhibitors are the most common and are frequently associated with acute kidney injury.
3. Acute Interstitial Nephritis:
The checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab activate host T cells to enhance tumor killing by preventing tumor ligand binding to cytotoxic T-lymphocyte antigen 4 and programmed death 1 receptors, which deactivate T cells. However, this effect causes loss of self-tolerance (and perhaps tolerance to other drugs), leading to various forms of autoimmune injury, including acute interstitial nephritis, which is associated with moderate-to-advanced-stage acute kidney injury.
That's all!
-VM
The immunohistological marker for melanoma is HMB 45.
You can remember it by remembering the gorilla named 'Harambe' (HaraMBe) of Cincinnati zoo who was in the news as he unfortunately had to be put down because a child entered his enclosure.
You can correlate melanoma's black pigment with that of Harambe's black fur.
That's all!
- Sushrut Dongargaonkar
Hello everybody,
So to continue our series on cutaneous manifestations of internal malignancies
Let's quickly learn about Bazex Syndrome.
Bazex syndrome — acrokeratosis
paraneoplastica is a paraneoplastic phenomenon associated with squamous cell carcinoma of the upper digestive tract.
Presents more commonly in Males and over the age of 40.
Presentation: Erythematous to violaceous psoriasiform plaques predominantly located in acral areas (especially the fingers, toes, nose, and helices).
Nail dystrophy, palmoplantar keratoderma, and alopecia are common.
In most patients, manifestations of Bazex syndrome precede the diagnosis of malignancy or the malignancy is diagnosed concurrently.
The lesions of Bazex syndrome are usually resistant to targeted therapies, but treatment of the neoplasm usually leads to resolution of the cutaneous findings, although not always.
Let's learn together!
-Medha!
Hello readers, here is the continuation of the previous topic, Immunohemolytic anemias. Today we will discuss the next two types, its more like winter special.
B) Cold agglutinin type- Cold agglutinin derives their name from the fact that they show maximal activity at temperature lower than normal body temperature.
It is present in low titres in healthy individuals.
Physiological cold agglutinin develops naturally after birth as a result of change in expression of Red cell antigens and reacts maximally at 4°C.
While pathological cold agglutinin maximally reacts at around 28-31° C and tend to occur at very low titres.
Mnemonic is "Cold MILL"
C - Complement mediated hemolysis.
M - IgM is the causative antibodies
I - Cold agglutinin antibodies appear
transiently following Infections
[Mycoplasma pneumoniae, EBV,
HIV, influenza virus, CMV]
- I antigen is the most common
target
L - Chronic cold agglutinin AIHA is
associated with Lymphoid
neoplasm
(esp B cell neoplasm), leukemias
like CLL
Mechanism- IgM binds to red cell where the temperature may fall below 30°C. It agglutinates red cells, and fixes complement rapidly. As blood recirculates and warms, IgM is released,but sufficient deposition of complements leads to phagocytosis of affected red cells in spleen, liver, bone marrow.
Clinical presentation- Exerts their pathological effects either via hemolysis and red cell destruction in RE system predominantly liver or by vaso occlusion due to agglutination.
-Mild anemia, purplish discoloration of fingers, toes, earlobes [ Acrocyanosis], mild hepatospleenomegaly,
Raynaud phenomenon in peripheral cold exposed parts.
C) Cold hemolysin type -
Also known as paroxysmal cold hemoglobinuria.
It's a rare fatal disorder causing intravascular hemolysis and hemoglobinuria when auto antibodies binds to P blood group antigens in cool, peripheral regions of body.
Paroxysmal Cold HemoGlobinuria:
P- P blood group antigens
C- Complement mediated lysis occurs.
IgGs auto antibodies binds to red cell in
cool peripheral regions, Complement
mediated lysis occurs when affected
red cell recirculates to warm regions,
because complement cascade
functions
more efficiently at 37°C
H- Hemoglobinuria
G - Auto antibodies belong to class IgG
Symptoms of the patients aggravates on exposure to cold.
Winter is coming, we know what's coming with it.
Stay warm :)
Hello awesomites!
This is my very first post, so am starting with my favorite subject Hematology.
Today's post is about Immunohemolytic anemias, commonly ignored type of anemia
Also referred as Autoimmune hemolytic anemias(AIHA)
Where antibodies are responsible for premature destruction of red blood cell.
Types- warm antibody type
- cold agglutinin type
- cold hemolysin type
Warm antibody type - It is the most common type of AIHA.
you can remember it by mnemonic
" WARM GRILLED "
W - Warm because, antibodies are active
at 37°C
A - Associated with other Autoimmune
disorders ( secondary causes like
SLE)
R - Red cell hemolysis is mainly
extravascular
M- Moderate spleenomegaly due to
hyperplasia of splenic phagocytes
G- Ig G class - most common causative
antibodies ( IgA sometimes too)
R- Rh blood group antigens are the main
target
I- 50% primary cases are Idiopathic
Secondary causes can be
L- Lymphoid neoplasm
ED- Exposure to Drugs.
Examples - penicillin, cephalosporins, quinidine, methyl dopa etc
Mechanism - A) Antigenic drugs-
Drugs such as penicillin binds to red cell membrane and they are recognized by the antidrug antibody. The antibody either recognizes the drug and bind to it or both drug and membrane protein,ultimately results in hemolysis.
B) Tolerance breaking drugs- In drugs such as methyl dopa, antibodies are formed against red cell antigens particularly Rh antigens.
Stay awesome✌️