1
40
2
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jid.2019.03.942" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jid.2019.03.942</a>
Pages
S150–S150
Issue
5
Volume
139
ISSN
0022-202X
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
866 Patient with paroxysmal nocturnal hemoglobinuria (PNH) and aplastic anemia presenting with progressive purpuric nodules
Publisher
An entity responsible for making the resource available
Journal of Investigative Dermatology
Date
A point or period of time associated with an event in the lifecycle of the resource
2019
2019-05
Subject
The topic of the resource
Dermatology
Creator
An entity primarily responsible for making the resource
Farid Y; Schneider S; Warren C; Vij A
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jid.2019.03.942" target="_blank" rel="noreferrer noopener">10.1016/j.jid.2019.03.942</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Description
An account of the resource
A 44 y/o woman with PNH and aplastic anemia presented with 5 months of progressive painful purpuric nodules. Examination revealed firm, pink to purple, tender nodules in her lower and upper extremities and trunk. Biopsy revealed an edematous dermis, focal erythrocyte extravasation, and rare vessels with fibrin thrombi. The subcutis showed adipocyte necrosis with fibrin deposition, hemorrhage, and abscess formation. Special stains and cultures were negative for fungi, bacteria, and mycobacteria. D-Dimer was significantly elevated. The patient was diagnosed with thrombotic vasculopathy secondary to PNH. PNH is rare diagnosis that may result as a complication of bone marrow disease. In this disorder, the patient acquires a mutation in the phosphatidylinositol glycan A (PIGA) gene that impairs synthesis of the GPI anchor protein on erythrocytes, leukocytes, and platelets. This results in impaired attachment of CD55 and CD59 proteins, which protect cells from complement mediated lysis. Complement mediated lysis leads to platelet aggregation and venous thrombosis, in addition to Coombs negative hemolytic anemia and pancytopenia. Thromboemboli are the leading cause of death in PNH patients and can result in dermatologic findings. Biopsy in our patient showed thrombosis and skin necrosis with no indication of vasculitis. Other presentations include hemorrhagic bullae formation, purpura fulminans, and painful ecchymotic plaques. Our treatment plan was to continue prednisone, resume eculizumab and cyclosporine, and add enoxaparin (based on her mild thrombocytopenia). Eculizumab is used in the treatment of PNH as it inhibits terminal complement formation. Our patient’s condition improved within 3 months. Testing for PNH is recommended in patients with unexplained thromboses and young patients with unusual site thrombosis (intrabdominal, cerebral, and dermal veins), hemolysis, and/or any cytopenia. Discovery of underlying PNH will modify the treatment plan and improve patient prognosis.
2019
Dermatology
Farid Y
Journal of Investigative Dermatology
June 2019 Update
NEOMED College of Medicine
NEOMED College of Medicine Student
NEOMED Student Publications
Schneider S
Vij A
Warren C
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/j.1553-2712.2010.00938.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1553-2712.2010.00938.x</a>
Rights
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
Pages
1286-1296
Issue
12
Volume
17
Search for Full-text
Locate full-text within NEOMED Library's e-journal collections
<p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Regionalization Of Emergency Care Future Directions And Research: Workforce Issues
Publisher
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Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
2010-12
Subject
The topic of the resource
departments; Emergency Medicine; impact; management; medicine residency; nurse-practitioners; on-call coverage; physicians; quality; shortage; surgeon
Creator
An entity primarily responsible for making the resource
Ginde A A; Rao M; Simon E L; Edwards J M; Gardner A; Rogers J; Lopez E; Camargo C A; Piazza G; Rosenau A; Schneider S; Jouriles N
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1553-2712.2010.00938.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2010.00938.x</a>
Format
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Journal Article or Conference Abstract Publication
2010
Academic Emergency Medicine
Camargo C A
departments
Edwards J M
Emergency Medicine
Gardner A
Ginde A A
impact
Jouriles N
Lopez E
Management
medicine residency
nurse-practitioners
on-call coverage
Physicians
Piazza G
quality
Rao M
Rogers J
Rosenau A
Schneider S
shortage
Simon E L
surgeon