Publications (10)9.82 Total impact
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Conference Proceeding: THE ROLE OF TRANSIENT ELASTOGRAPHY IN THE ASSESSMENT OF LIVER FIBROSIS IN PATIENTS WITH MYELODYSPLASTIC SYNDROMES
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ABSTRACT: BACKGROUND: Myelodysplastic syndromes (MDS) are hematopoietic stem cell malignancies characterized by ineffective blood cell production. Most MDS patients eventually become red blood cell (RBC) transfusion dependent, risking iron overload, which may lead to cardiac and hepatic failure. Due to increase risk of complications, hematologists do not recommend liver biopsy to assess liver iron concentration and use other non-invasive methods such as serum ferritin level. Liver transient elastography (TE, Fibrocan®-Echosens Paris) is an exciting new technology that allows the estimation of hepatic fibrosis through the measurement of liver stiffness. AIMS: Our aim was to explore possible associations of liver stiffness measured with TE with transfusion overload and ferritin levels in a group of patients with MDS. METHODS: All patients with MDS attending our outpatient hematological clinic from June 2010 to April 2011 were included in the study. Patients with other causes of chronic liver disease were excluded. The monitoring of transfusion burden was made through blood bank transfusion tracking data. We performed TE in all patients. The following variables were collected the same day of TE evaluation: serum ferritim, hemoglobin, platelets count, serum aminotransferases, gammaglutamiltransferase (GGT), total bilirubin level. RESULTS: Twenty patients with MDS syndrome were studied. Seventeen (85%) were male, whereas mean age was 74 years (range, 60-87 years). Mean BMI was 24.46 Kg/m2. Mean TE values were 13.68 kPa (range, 3.6-70.7 kPa). The mean ferritin level was 1603 ng/mL. Eleven patients (55%) were diagnosed with high risk MDS and mean TE values were 16.77 kPa in this subgroup. Five patients were receiving iron chelation for a mean of 30 months therapy before TE evaluation. In the group without any chelation treatment, mean TE value was 16.23 kPa (range, 4.8-70.7kPa) while 6 patients had TE value above 12 kPa. However, in the group receiving chelation treatment, the mean TE value was 6.02 kPa (range, 3.6-7.8 kPa), [P=0.23]. Demographic data and transfusion overload were not found to be correlated with TE values (P=0.56). Serum ferritin levels were found to be related to log-transformed TE value (P = 0.004). GGT levels were found to affect TE values (P<0.001). CONCLUSIONS: In the current study, liver stiffness was found to be correlated with ferritin serum level. TE could be a promising non-invasive tool for the assessment of chelation therapy on liver fibrosis in patients with MDS syndromes and post-transfusion iron overload.62nd AASLD, San Francisco; 11/2011 -
Article: Concomitant diagnosis of myeloproliferative neoplasm and non-Hodgkin's lymphoma in a patient with portal vein thrombosis.
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ABSTRACT: We describe here the rare coexistence, at the time of diagnosis, of a myeloproliferative neoplasm (MPN) and non-Hodgkin's lymphoma (NHL) in a 74-year-old patient who presented with thrombocytosis and signs of portal hypertension on physical examination. Abdominal computed tomography scan demonstrated extensive portal vein system thrombosis. Secondary causes of thrombocytosis were excluded. JAK2 V617F mutation was present in the peripheral blood, while bone marrow biopsy revealed marginal zone B-cell lymphoma. Molecular analysis failed to detect BCR-ABL rearrangement in peripheral blood cells. Simultaneous occurrence of MPN and NHL was diagnosed. This case may be of interest not only due to the rare coexistence of PMN and NHL, but also because of the undetermined clinical significance of JAK2 mutation in this subset of patients.Anticancer research 04/2011; 31(4):1467-9. · 1.73 Impact Factor -
Article: Development of non-Hodgkin's lymphoma in a patient with primary biliary cirrhosis: A case report and review of the literature
Annals of Gastroenterology 01/2011; 24:125-128. -
Article: Langerhans cell histiocytosis presenting as a primary penile lesion
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ABSTRACT: Langerhans cell histiocytosis presenting as a primary penile lesion with a solitary nodular lesion on the prepuce, 1.2 cm in maximum diameter, reddish with a smooth surface. His clinical examination was unremarkable and no similar lesions were noted elsewhere. Surgical resection of the nodule was performed and histological assessment revealed infiltration of neoplasmic cells, some of which were giant cells with oval, indented nuclei, a small degree of nuclear atypia and eosinophilic cytoplasm. Eosinophils were not observed in the histology sample. Immunochemistry results were positive for vimentin, S-100 protein, CD1a and Langerin, whiler the neoplasmic cells were negative for keratins AE1/AE3, SM-actin, HHF-35, Desmin, CD34 and CD99. The proportion of cell prolif-eration, Ki-67+, was almost 20%. These findings were consistent with the diagnosis of LCH. Investigation for metastases, including computed tomography (CT) of the thorax and abdomen, 99m TC bone scan, and bone marrow aspiration revealed no evidence of disease beyond the penis. The patient was not given any medi-cal treatment but was monitored closely as an outpatient in the hematological department, as cutaneous LCH could represent the initial presentation of the multisystem disease of LCH. 3 COMMENT LCH of the penis is very rare cutaneous lesion. Its etiol-ogy remains unknown and association with various stimuli, such as chemical or viral exposure, has not been proved. Review of the relevant literature revealed reports of seven additional cases of LCH presenting as a penile lesion, which were treated by surgical excision or topical steroid ointments, or chemotherapy in the case of multisystem involvement. The outcome in all cases was excellent and there are no reports of recurrence of the disease in the penis. 2 Cases of non-Langerhans cell histiocytosis have also been reported. Juvenile xanthogranuloma (JXG) is the commonest variant of non-Langerhans cell histiocytosis, and only four cases with a penile lesion have been reported. 4 In addition, one case of intermediate cell histiocytosis presenting as a solitary lesion of penis has been reported. 5 The prognosis of solitary penile lesions of LCH is excel-lent, with no reports of recurrence of the disease. Neverthe-less, careful assessment should be made for any systemic involvement and close monitoring is recommended.Archives of Hellenic Medicine 01/2011; 28:709-710. -
Article: Sarcoid-like granulomatosis in patients treated with anti-TNFα factors. A case report and review of the literature.
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ABSTRACT: This report describes a 56-year-old woman who developed granulomatous lesions consistent with sarcoidosis during adalimumab therapy for rheumatoid arthritis. Cervical and axillary lymphadenopathy developed approximately 21 months after adalimumab administration. Non-caseating epithelioid cell granulomas consistent with sarcoidosis were detected both in an axillary lymph node specimen and in the bone marrow. Diseases showing similar histologic changes, especially tuberculosis, were excluded, and a diagnosis of sarcoidosis was made. Adalimumab was discontinued, and recovery was observed. The current case is, to our knowledge, the first to describe adalimumab-induced non-caseating granulomas in lymph nodes and bone marrow without pulmonary involvement in a patient treated for rheumatoid arthritis.Clinical Rheumatology 10/2010; 30(4):581-3. · 2.00 Impact Factor -
Article: An extranodal NK/T cell lymphoma, nasal type, with specific immunophenotypic and genotypic features.
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ABSTRACT: Extranodal NK/T cell lymphoma, 'nasal type,' is a rare clinicopathological entity in Europe. The main clinical features are nasal congestion, sore throat, dysphagia and epistaxis, due to a destructive mass involving the midline facial tissues. Pathologically, lymphoma cells exhibit angioinvasion, angiodestruction and coagulative necrosis. We report the case of a patient who presented with fever, dyspnea, nasal congestion, headache, distention of right nasal turbinates and exophytic lower leg ulcerating lesions. A CT scan of visceral scull demonstrated a filling mass of right frontal, ethmoidal and maxillary sinuses with erosion of the wall of right maxillary sinus and ventral portion of the diaphragm. A biopsy was performed in the skin lesion and showed an angioinvasive NK/T cell lymphoma CD56 negative with clonal rearrangement of the T-cell-receptor gamma gene. Up to our knowledge, this is a rare immunophenotype for NK/T-cell, 'nasal type,' lymphomas. However, the lymphoma may be classified as extranodal NK/T cell lymphoma, 'nasal type,' due to typical clinical presentation, radiologic findings and pathological characteristics of polymorphism, angioinvasion, angiodestruction and coagulative necrosis.International Journal of Hematology 09/2008; 88(2):202-5. · 1.27 Impact Factor -
Article: Dilated cardiomyopathy during the course of hemolytic uremic syndrome.
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ABSTRACT: A 47-year-old woman presented with severe hemolytic uremic syndrome (HUS) followed by heart failure. An echocardiogram showed an ejection fraction of 20%, and a cardiac catheterization followed by a myocardial histologic evaluation demonstrated dilated cardiomyopathy. Plasma exchange and hemodialysis were performed regularly. The later outcomes of renal function and cardiomyopathy were favorable. A review of the literature confirmed the rare and severe nature of cardiac lesions occurring in the course of HUS. This case indicates the importance of cardiac monitoring in HUS and the need for prolonged support.International Journal of Hematology 12/2007; 86(4):333-6. · 1.27 Impact Factor -
Article: First case of Penicillium marneffei fungemia in Greece and strain susceptibility to five licensed systemic antifungal agents and posaconazole.
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ABSTRACT: We report the first case of Penicillium marneffei infection in a Greek bisexual man who is a frequent traveler to China. Penicilliosis and AIDS were diagnosed and antifungal treatment plus highly active antiretroviral therapy were administered successfully. In nonendemic areas travel history, clinical suspicion and laboratory alertness are critical for infection management.The American Journal of the Medical Sciences 08/2006; 332(1):43-5. · 1.39 Impact Factor -
Article: Angioimmunoblastic T-cell lymphoma-associated arthritis: case report and literature review.
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ABSTRACT: Angioimmunoblastic T-cell lymphoma (AITL) is a rare type of non-Hodgkin lymphoma with systemic manifestations, including fever, lymphadenopathy, rash, and rarely arthritis. We report the case of a patient who presented with symmetric inflammatory polyarthritis and skin nodules resembling rheumatoid arthritis (RA). The patient responded initially to low-dose prednisolone, but 12 months later, he developed typical features of AITL. The characteristics of AITL-associated arthritis from 16 additional cases from the English literature are also reviewed. AITL-associated arthritis is an uncommon manifestation of angioimmunoblastic lymphoma that can mimic RA, especially when the typical systemic features of lymphoma are absent. This type of arthritis should be included in the differential diagnosis of patients presenting with an inflammatory polyarthritis.JCR Journal of Clinical Rheumatology 01/2006; 11(6):326-8. · 1.36 Impact Factor -
Article: Isolated native tricuspid valve Candida endocarditis in a non-drug-addicted patient: case report and review of the literature.
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ABSTRACT: A case is reported of isolated native tricuspid calve Candida parapsilosis endocarditis (INTVCE) in a male patient with no history of drug abuse or heart disease. The patient had received hyperalimentation and antibiotics for four months via a central venous catheter after abdominal surgery. He underwent successful treatment with tricuspid valve debridement, liposomal amphotericin (AmBisome) and fluconazole, and remained without relapse during an eight-year follow up. A literature review of 12 similar cases (including the present patient) without history of drug abuse or heart disease, dating from 1970, is included.The Journal of heart valve disease 10/2003; 12(5):652-8. · 0.81 Impact Factor
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Institutions
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2006–2011
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Hippokration General Hospital, Athens
Athens, Attiki, Greece -
National Technical University of Athens
Athens, Attiki, Greece
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