Dasatinib-induced chylothorax beyond 5 years of treatment: is there actually any limit?

Dasatinib is a tyrosine kinase inhibitor used for treatment of some specific types of leukaemia. The development of pleural effusion is a known adverse effect of dasatinib and chylothorax is exceptional. No case has been reported beyond 5 years of treatment and extensive search for an alternative diagnosis is currently suggested in such scenario. The underlying mechanism is not currently clear. We describe a woman on dasatinib treatment for more than 10 years who developed chylothorax. Drug withdrawal resolved the chylous pleural effusion. We were able to find 14 additional cases of dasatinib-related chylothorax reported up until now

Diagnostic Accuracy of Adenosine Deaminase and Lymphocyte Proportion in Pleural Fluid for Tuberculous Pleurisy in Different Prevalence Scenarios

BACKGROUND: Tuberculous pleural effusion (TPE) is a paucibacillary manifestation of tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Adenosine deaminase (ADA) is the most cost-effective pleural fluid marker and is routinely used in high prevalence settings, whereas its value is questioned in areas with low prevalence. The lymphocyte proportion (LP) is known to increase the specificity of ADA for this diagnosis. We analyse the diagnostic usefulness of ADA alone and the combination of ADA ≥ 40 U/l (ADA(40)) and LP ≥ 50% (LP(50)) in three different prevalence scenarios over 11 years in our area. MATERIALS AND METHODS: Biochemistry, cytology and microbiology studies from 472 consecutive pleural fluid samples were retrospectively analyzed. ADA and differential cell count were determined in all samples. We established three different prevalence periods, based on percentage of pleural effusion cases diagnosed as tuberculosis: 1998-2000 (31.3%), 2001-2004 (11.8%), and 2005-2008 (7.4%). ROC curves, dispersion diagrams and pre/post-test probability graphs were produced. TPE accounted for 73 episodes (mean prevalence: 15.5%). The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for ADA(40) were 89%, 92.7%, 69.2% and 97.9%, respectively. For ADA(40)+LP(50) the specificity and PPV increased (98.3% and 90%) with hardly any decrease in the sensitivity or NPV (86.3% and 97.5%). No relevant differences were observed between the three study periods. CONCLUSIONS/SIGNIFICANCE: ADA remains useful for the diagnosis of TPE even in low-to-intermediate prevalence scenarios when combined with the lymphocyte proportion

Mundo Heterogeneo-EA77-201901

Mundo Heterogéneo es un curso de la carrera de Artes Escénicas de carácter teórico dirigido a los estudiantesdel IV ciclo.Uno de los principales problemas que separa a los seres humanos es la incapacidad de ponerse en el sitio delOtro. La empatía es la actitud que nos prepara justamente para poder entender a ese otro. Dentro de las CienciasSociales la Antropología en la medida en que ha convertido a La Cultura en su objeto de estudio se manifiestacomo la disciplina capaz de poder hacer entender racionalmente la lógica por las cuales los seres humanoshemos sido capaces de crear un mundo heterogéneo.De esta manera los conocimientos que brinda el curso resultan fundamentales para el análisis y comprensiónemocional de un mundo heterogéneo y sirve como base para poder iniciar actividades propias de la carrera deArtes Escénicas.Propósito:El curso busca desarrollar las competencias generales de Pensamiento Crítico y Ciudadanía y la competenciaespecífica de Autoconocimiento y Empatía todas en su Nivel 2. No tiene prerrequisitos

Cases of tuberculosis pleural effusion (TPE) and malignant effusion as a function of age.

<p>Cases of tuberculosis pleural effusion (TPE) and malignant effusion as a function of age.</p

ADA levels by type of pleural effusion in three tuberculosis pleural effusion prevalence periods (1998–2000, prevalence: 31.3%; 2001–2004, prevalence: 11.8%; and 2005–2008, prevalence: 7.4%).

<p>CTPE: confirmed pleural tuberculosis; PTPE: probable pleural tuberculosis; CPE: complicated parapneumonic effusion; UPE: uncomplicated parapneumonic effusion.</p

ROC curve.

<p>ROC curve.</p

Prevalence of TPE (bars) and incidence rate of tuberculosis (line) in the Bajo Deba Area, Gipuzkoa, Basque Country (1998–2008).

<p>Prevalence of TPE (bars) and incidence rate of tuberculosis (line) in the Bajo Deba Area, Gipuzkoa, Basque Country (1998–2008).</p

Bayesian probabilities of test parameters used. ADA ≥40 U/L.

<p>Bayesian probabilities of test parameters used. ADA ≥40 U/L.</p

Bilateral pleural effusion and interstitial lung disease as unusual manifestations of kikuchi-fujimoto disease: case report and literature review

<p>Abstract</p> <p>Background</p> <p>Kikuchi-Fujimoto's disease (KFD), also called histiocytic necrotizing lymphadenitis, is a rare, idiopathic and self-limited condition usually characterized by cervical lymphadenopathy and fever, most often affecting young patients. Aetiology is unknown. Differential diagnosis includes mainly malignant lymphoma, tuberculous lymphadenitis and systemic lupus erythematosus (SLE), so early diagnosis is crucial. Pleuropulmonary involvement due to isolated KFD has been seldom reported.</p> <p>Case Presentation</p> <p>a 32-year-old man, on treatment for iatrogenic hypothyroidism, was admitted due to high grade fever and painful cervical lymphadenopathies. KFD was diagnosed by lymph node biopsy. Some days after admission the patient got worse, he developed generalized lymphadenopathy, bilateral pleural effusion and interstitial lung disease. All of them resolved with prednisone and after two years of following up he remains asymptomatic and without evidence of any other associated disease.</p> <p>Conclusion</p> <p>Pleural effusion and interstitial lung disease are very uncommon manifestations of KFD. In our experience, treatment with oral prednisone was effective.</p