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Pneumococcal infection transmission between family members with congenital asplenia: A case report

World Journal of Clinical Cases 2019年第24期7卷 4277-4284页

作者： Jumpei Shibata Kazuhiro Hiramatsu Tuneaki Kenzaka Takehito Kato Department of General Surgery Toyohashi Municipal Hospital50 Aza Hachiken NishiAotake-ChoAichi 4418570ToyohashiJapan Division of Community Medicine and Career Development Kobe University Graduate School of MedicineHyogo 6520032KobeJapan

BACKGROUND asplenia,the lack of a spleen,can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria,such as Streptococcus pneumoniae(***).We report two cases of severe pneumococcal infection in two asplenic family members living in the same *** SUMMARY Patient 1,a 38-year-old man with a history of congenital hepatitis B infection and hypospadias,was brought to our emergency department with complaints of cyanosis,cough,and edema of his *** was clinically diagnosed as hyposplenic with overwhelming pneumococcal *** was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after *** 2,a 63-year-old woman with a history of type 2 diabetes,was brought to our emergency department one month after admission of Patient *** was diagnosed as asplenic with overwhelming pneumococcal ***-taking revealed that she was the mother of Patient 1 and the two had lived in the same *** was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after *** Pneumococcal bacteremia caused by virulent *** may be transmitted within *** residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of *** members of patients with congenital asplenia/hyposplenia,all family members should be examined to assess their splenic function.

关键词： Streptococcus pneumoniae Pneumococcal infection asplenia Hyposplenia Isolated congenital asplenia Septic shock Case report

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Impact of pretransplant asplenia vaccination on anti-A/B antibody titers in prospective ABO incompatible kidney transplant recipients

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Rheumatology & Autoimmunity 2023年第1期3卷 26-34页

作者： Elisa Bongetti Mauro S.Sandrin William R.Mulley Department of Nephrology Monash HealthClaytonVictoriaAustralia Department of Surgery Austin Health/Northern HealthThe University of MelbourneHeidelbergVictoriaAustralia

Background:asplenia vaccination is employed before ABO-incompatible(ABOi)transplantation in case splenectomy is *** vaccines have been reported,in different patient groups,to increase anti-A/B titers,through cross-reactivity to shared polysaccharide *** investigated the impact of pretransplant asplenia vaccinations on anti-A/B antibody titers in prospective ABOi renal transplant ***:Published asplenia vaccine microbial structures were reviewed to assess expression of A/B *** patients who underwent ABOi transplantation at Monash Medical Centre with anti-A/B titers taken either side of asplenia vaccination were included in a retrospective cohort study between 2007 and *** with paired titers without intervening vaccination were included as *** titers were compared within ***:A and B antigens were found to be expressed by vaccine specific pneumococcal ***-nine ABOi renal transplant recipients received vaccination including at least one pneumococcal *** most common donor to recipient combination was A1 to *** median pre-and postvaccination anti-A/B titers were 1:32 and there was no significant change in titers following vaccination(median change in titer 0 dilutions,range–2 to 3,P=0.43).The same findings were apparent in the control group(n=20).There was no significant change in titer by donor blood group or vaccine *** transplants were canceled or delayed by a rise in anti-A/B titers ***:Pneumococcal vaccination had no clinically relevant impact on anti-A/B titers before ABOi transplantation in this *** results provide reassurance regarding the safety of asplenia vaccination before ABOi transplantation.

关键词： ABO blood-group system asplenia kidney transplantation molecular mimicry splenectomy vaccination

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Liver-spleen axis dysfunction in COVID-19

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World Journal of Gastroenterology 2021年第35期27卷 5919-5931页

作者： Sara Cococcia Marco Vincenzo Lenti Giovanni Santacroce Giovanna Achilli Federica Borrelli de Andreis Antonio Di Sabatino First Department of Internal Medicine San Matteo Hospital FoundationUniversity of PaviaPavia 27100Italy Department of Gastroenterology Royal Free HospitalLondon NW32QGUnited Kingdom

Coronavirus disease 2019(COVID-19),caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is an acute infectious disease that spreads mainly through the respiratory *** interstitial pneumonia,a number of other clinical manifestations were noticed in COVID-19 *** particular,liver and spleen dysfunctions have been described both as complications of COVID-19 and as potential predisposing factors for severe *** damage is rather common in COVID-19 patients,and it is most likely multifactorial,caused by the direct insult of SARS-CoV-2 to the liver by the cytokine storm triggered by the virus,by the use of hepatotoxic drugs,and as a consequence of *** generally mild,liver impairment has been found to be associated with a higher rate of intensive care unit admission.A higher mortality rate was reported among chronic liver disease ***,spleen impairment in patients with COVID-19 has been poorly *** main anatomical changes are the architectural derangement of the B cell compartment,white pulp atrophy,and reduction or absence of lymphoid follicles,while,from a functional point of view,the IgM memory B cell pool is markedly *** outcome of COVID-19 in asplenic or hyposplenic patients is yet to be *** this review,we will summarise the current knowledge regarding the impact of SARS-CoV-2 on the liver and spleen function,as well as the outcome of patients with a pre-existent liver disease or defective spleen function.

关键词： asplenia Chronic liver disease IgM memory B cell Liver transplantation Transaminase

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Classifying Cardiac Anomalies in Right and Left Isomerism:Concordant and Discordant Patterns

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Congenital Heart Disease 2023年第1期18卷 97-111页

作者： Lilia Oreto Giuseppe Mandraffino Paolo Ciliberti Teresa P.Santangelo Placido Romeo Antonio Celona Placido Gitto Lorenzo Galletti Fiore S.Iorio Alfredo Di Pino Aurelio Secinaro Paolo Guccione Robert H.Anderson Salvatore Agati Mediterranean Pediatric Cardiology Center Bambino GesùChildren’s HospitalVia SirinaTaorminaItaly Internal Medicine Unit Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly Department of Pediatric Cardiology and Cardiac Surgery Bambino GesùChildren’s HospitalRomaItaly Advanced Cardiovascular Imaging Unit Department of ImagingBambino GesùChildren’s HospitalRomaItaly Radiology Department S.Vincenzo HospitalTaorminaItaly Biosciences Institute Newcastle UniversityNewcastle upon TyneUK

Aims:Evidence is emerging that,in the setting of isomerism,the atrial and bronchial arrangement are not always concordant,nor are these patterns always harmonious with the arrangement of the abdominal *** aimed to evaluate the concordance between these features in a cohort of patients with cardiac malformations in the setting of known isomerism,seeking to determine whether it was feasible to assess complexity on this basis,in this regard taking note of the potential value of bronchial as opposed to appendage *** and Results:We studied 78 patients known to have isomerism of the bronchuses,43 with right and 35 with left *** anatomy could be determined in 49 cases(63%),all but one of these being concordant with bronchial *** assessing abdominal features,in only 59 cases(76%)was splenic morphology in keeping with the thoracic *** expected,right isomerism was associated with greater complexity of cardiac malformations,with an odds ratio of 6.53,with confidence intervals from 2.2–19.3(p<0.001).The odds were slightly decreased with thoraco-abdominal disharmony,when lesions shown to carry higher risk were then found in the setting of left ***:Harmony is excellent between bronchial and appendage isomerism,but less so with the arrangement of the abdominal *** isomerism in our cohort,was indicative of a sixfold increase in intracardiac *** discordance was found between the systems,however,the cardiac anomalies were less typical of the anticipated findings for right *** isomerism of the appendages.

关键词： Isomerism asplenia polysplenia congenital heart disease bronchial isomerism atrial appendages

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