Down syndrome with microgranular variant of acute promyelocytic leukemia in a child: a case report

<p>Abstract</p> <p>Background</p> <p>Acute promyelocytic leukemia (APL) accounts for less than 10% of pediatric AML. Cases of APL in Down syndrome (DS) have been described in the literature rarely and it is rarer still to find the microgranular variant (M3v) of APL in trisomy 21 patients.</p> <p>Case presentation</p> <p>We present a case of a five-year-old female with Down syndrome diagnosed with acute promyelocytic leukemia (APL). She came to our hospital with bleeding manifestations. Blood and bone marrow examination revealed promyelocytes showing a few fine granules and occasional Auer rods. Based on this morphology and cytochemistry, a diagnosis of APL microgranular variant (M3v) was made.</p> <p>Conclusion</p> <p>This case report emphasizes the importance of a high index of suspicion in the diagnosis of acute promyelocytic leukemia microgranular variant in Down syndrome.</p

Red cell distribution width is associated with mortality in kidney transplant recipients

Background: Red cell distribution width (RDW), a parameter routinely reported as part of the complete blood count, is associated with increased morbidity and mortality risk in different patient populations. No published data are available about the association between RDW and mortality in kidney transplant recipients. Methods: We collected socio-demographic, clinical parameters, medical and transplant history and laboratory data at baseline in 723 prevalent kidney transplant recipients between June and October 2008 [mean age 51 ± 13 (SD) years, 56 % men, 21 % diabetics]. Associations between baseline RDW values and all-cause mortality over 3 years were examined in unadjusted and adjusted models. Results: Increasing RDW was associated with increased mortality in both unadjusted [(HR1 % increase = 1.63; 95 % CI 1.41-1.89) and (HR>median = 2.74; 95 % CI 1.68-4.48)] and fully adjusted models [(HR1 % increase = 1.60; 95 % CI 1.27-1.89) and (HR>median = 1.33; 95 % CI 0.76-2.35)]. In reclassification analyses, RDW improved the predictive value of all-cause mortality prediction models [the net reclassification improvement (NRI) was 0.189; p < 0.001]. Conclusions: RDW, a cheap and readily available but largely neglected parameter independently, predicts mortality in prevalent kidney transplant recipients and could potentially been used in everyday risk assessment of kidney transplant recipients. © 2013 Springer Science+Business Media Dordrecht