Fulminant hyperpyrexia induced by bleomycin

Mild and self-limiting fever following bleomycin use is common, and a fatal hyperpyrexial response occurs rarely. In previously reported cases, such hyperpyrexia occurred either after the initial administration of the drug or during subsequent therapy following an initial pyrexial response. We describe a fatal hyperpyrexial reaction after bleomycin in a patient with T-cell lymphoma who had had no febrile response when she received her initial injection 3 weeks earlier. Since the occurrence of this hyperpyrexial response is unpredictable, health care workers as well as patients and relatives should always be alert to this potentially lethal complication and prompt measures should be taken in any patient who develops fever after bleomycin use.published_or_final_versio

1H magnetic resonance spectroscopy of nanomelic chicken cartilage: effect of aggrecan depletion on cartilage T2

AbstractObjective: To determine the effect of proteoglycan depletion on cartilage proton magnetic resonance (MR) spectroscopy T2using nanomelic chicken cartilage, a genetic mutant that completely lacks aggrecan.Design: Proton MR spectroscopic T2measurements of normal embryonic and nanomelic femoral epiphyseal cartilage were obtained using a 96-echo pulse sequence with inter-echo delay times increased logarithmically over the TE period of 60 μs to 1.7 s. The relative intensity and distribution of cartilage T2components were determined by fitting signal decay curves to a multi-exponential function. The number of T2components in the signal decay curves was determined by the degree of freedom limited r2of the fit.Results: For normal fetal chicken cartilage, 97.6±0.2% (mean±95% confidence interval) of the total signal comprises a long T2component (179.1±1.3 ms) with a relatively small short T2component (0.5±0.4 ms). The T2distribution for nanomelic cartilage is more heterogeneous with four components identified: two short T2components (0.5±0.02 and 7.3±0.6 ms), a large intermediate component (56.4±5.6 ms), and a broadly distributed long component (137.5±16.6 ms). In nanomelic cartilage there is greater heterogeneity of cartilage T2indicating greater variation in water proton mobility and exchange of water with the extracellular matrix.Conclusion: Absence of aggrecan in the extracellular cartilage matrix produces greater heterogeneity in cartilage T2, but will not increase T2as has been previously reported with degenerative change of the collagen matrix