IVIG Induced Hemolytic Anemia

Intravenous immunoglobulin (IVIG) is derived from donated plasma used to treat immune deficiency, autoimmune, and inflammatory disorders. Adverse effects occur in 5-15% of patients with hemolytic anemia being a delayed reaction. Risk factors for hemolysis are high-dose infusions (1-2g/kg/day or \u3e100g/day), female sex, and non-O blood group. Our case involves a 69-year old male presetting with bilateral lower extremity weakness for 1 year after sustaining a fall, affecting his ability to ambulate with no bowel or urinary incontinence. MRI revealed spondylotic changes of the lumbar spine. EMG showed severe bilateral lumbosacral polyradiculopathy with ongoing denervation and severe sensorimotor peripheral polyneuropathy with axonal loss. He was diagnosed with chronic inflammatory demyelinating polyneuropathy and started on high-dose IVIG (0.4mg/kg; 77.6mg) therapy for 5 days. 48 hours after IVIG completion, patient developed acute drop in hemoglobin (9.1 g/dL to 7.0 g/dL) that continued to down-trend (5.7 g/dL). Type and screen was AB positive. Labs were significant for elevated absolute reticulocyte count (141.5 K/uL), reticulocyte percentage (6.1%), and LDH (321 IU/L) while haptoglobin was low (\u3c30.0 mg/dL), consistent with hemolytic anemia. Direct antiglobulin anti-IgG coombs test was positive and anti-complement negative, consistent with immunohemolytic anemia. He was supported with blood transfusion and continued on high-dose Prednisone (1mg/kg/day) for 3 months. Antibodies present in IVIG product react with RBC antigens predominantly of the ABO blood group, causing intravascular hemolysis. Although IVIG induced hemolysis is typically mild and self-limiting, it can often go undetected and prescribers should be aware.https://scholarlycommons.henryford.com/merf2020caserpt/1138/thumbnail.jp

Detection of somatostatin receptors in human osteosarcoma

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Diorganotin Complexes of a Thiosemicarbazone, Synthesis: Properties, X-Ray Crystal Structure, and Antiproliferative Activity of Diorganotin Complexes

The synthesis and spectral characterization of novel diorganotin complexes with 3-hydroxypyridine-2-carbaldehyde thiosemicarbazone, H(2)L (1), [SnMe(2)(L)] (2), [SnBu(2)(L)] (3), and [SnPh(2)(L)] (4) are reported. The single-crystal X-ray structure of complex [SnPh(2)(L)(DMSO)] (5) shows that the ligand is doubly deprotonated and is coordinated as tridentate ligand. The six coordination number is completed by two carbon atoms of phenyl groups. There are two similar monomers 5a (Sn1) and 5b (Sn51) in the asymmetric unit. The monomers 5a and 5b are linked through intermolecular hydrogen bonds of N-H-O and C-H-S type. C-H -> pi, intermolecular interactions, intra-and intermolecular hydrogen bonds stabilize this structure and leads to aggregation and a supramolecular assembly. The IR and NMR ((1)H, (13)C and (119)Sn) spectroscopic data of the complexes are reported. The in vitro cytotoxic activity has been evaluated against the cells of three human cancer cell lines: MCF-7 (human breast cancer cell line), T-24 (bladder cancer cell line), A-549 (nonsmall cell lung carcinoma) and a mouse L-929 (a fibroblast-like cell line cloned from strain L). Compounds 1, 3, and 4 were found active against all four cell lines. Selectivity was observed for complexes 3 and 4 which were found especially active against MCF-7 and T-24 cancer cell lines.Bioinorg Chem App

Organotin Compound Derived from 3-Hydroxy-2-formylpyridine Semicarbazone: Synthesis, Crystal Structure, and Antiproliferative Activity

The novel diphenyltin(IV) compound [Ph(2)(HyFoSc)Sn] (2), where H(2)HyFoSc (1) is 3-hydroxy-2-formylpyridine semicarbazone, was prepared and characterized by vibrational and NMR ((1)H, (13)C) spectroscopy. The structure of [Ph(2)(HyFoSc)Sn] was confirmed by single-crystal X-ray crystallography. The doubly deprotonated ligand is coordinated to the tin atom through the enolic-oxygen, the azomethine-nitrogen, and phenolic-oxygen, and so acts as an anionic tridentate ligand with the ONO donors. Two carbon atoms complete the fivefold coordination at the tin( IV) center. Intermolecular hydrogen bonding, C-H -> pi, and pi -> pi interactions combine to stabilize the crystal structure. Compounds 1 and 2 have been evaluated for antiproliferative activity in vitro against the cells of three human tumor cell lines: MCF-7 (human breast cancer cell line), T24 (bladder cancer cell line), A549 (nonsmall cell lung carcinoma), and a mouse fibroblast L-929 cancer cell line.Bioinorg Chem App

Clinical and Epidemiologic Characterization of WU Polyomavirus Infection, St. Louis, Missouri

WU polyomavirus is a recently described polyomavirus found in patients with respiratory infections. Of 2,637 respiratory samples tested in St. Louis, Missouri, 2.7% were positive for WU polyomavirus by PCR, and 71% were coinfected with other respiratory viruses. Persistent human infection with WU polyomavirus is described

Central Bank Communication in the Financial Crisis: Evidence from a Survey of Financial Market Participants

In this paper, we study whether central bank communication has a positive effect on market participants' perception of central banks' (i) credibility, (ii) unorthodox measures, and (iii) independence. We utilise a survey of more than 500 financial market participants from around the world who answered questions in reference to the Bank of England (BoE), the Bank of Japan (BoJ), the European Central Bank (ECB), and the Federal Reserve (Fed). We find that market participants believe that the Fed communicates best, followed by the BoE, ECB, and BoJ. Similar rankings are found on the issues of credibility, satisfaction with unconventional monetary policy, and possible deterioration in independence. Using ordered probit models, we show that central bank communication has a positive effect on how central banks are perceived and understood, as it enhances credibility, increases satisfaction with unorthodox measures, and fosters perceived independence of central banks

Investigating the Monetary Policy of Central Banks with Assessment Indicators

This paper outlines a new method for using qualitative information to analyze the monetary policy strategy of central banks. Quantitative assessment indicators that are extracted from a central bank's public statements via the balance statistic approach are employed to estimate a Taylor-type rule. This procedure allows to directly capture a policymaker's assessments of macroeconomic variables that are relevant for its decision making process. As an application of the proposed method the monetary policy of the Bundesbank is re-investigated with a new dataset. One distinctive feature of the Bundesbank's strategy consisted of targeting growth in monetary aggregates. The analysis using the proposed method provides evidence that the Bundesbank indeed took into consideration monetary aggregates but also real economic activity and inflation developments in its monetary policy strategy since 1975