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  1. Article ; Online: Anticoagulation for Stroke Prevention after Restoration of Haemostasis with Emicizumab in Acquired Haemophilia A

    Kadhim Al-Banaa / Nicolas Gallastegui-Crestani / Annette von Drygalski

    European Journal of Case Reports in Internal Medicine (2021)

    2021  

    Abstract: Acquired haemophilia A (AHA) is a rare haemorrhagic disorder caused by the development of autoantibodies inhibiting factor VIII function. It predominantly affects the elderly, who are often burdened with a considerable number of comorbidities, and can ... ...

    Abstract Acquired haemophilia A (AHA) is a rare haemorrhagic disorder caused by the development of autoantibodies inhibiting factor VIII function. It predominantly affects the elderly, who are often burdened with a considerable number of comorbidities, and can result in life-threatening bleeding. The management of AHA consists of two aspects: inhibitor eradication with an immunomodulator and bleed control with a bypassing agent. Here we present a case of AHA with a high titre inhibitor in a patient with extensive comorbidities and atrial fibrillation in whom inhibitor eradication could not be achieved within a few weeks using corticosteroids alone. Due to coronavirus disease (COVID)-19 restrictions and complications of care, emicizumab offered an effective and convenient therapy, not only sparing the need for continued and intensified inhibitor eradication, but also allowing anticoagulation for stroke prophylaxis.
    Keywords acquired haemophilia a ; haemorrhage ; emicizumab ; anticoagulation failure ; venous thromboembolism ; atrial fibrillation ; Medicine ; R
    Language English
    Publishing date 2021-11-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: The vagaries of IgM

    Raai Mahmood / Khalid Mohamed / Naba Saeed / Kadhim Al-Banaa / Jonathan Zimmerman / Cecilia Big

    The Egyptian Journal of Internal Medicine, Vol 32, Iss 1, Pp 1-

    a case report of EBV infection with concomitantly false-positive IgM for CMV, VZV, and HSV

    2020  Volume 3

    Abstract: Abstract Background Serum IgM (immunoglobulin M) testing is commonly used to diagnose acute viral infections. However, most clinicians are unaware of the vagaries of IgM testing, including antigenic cross-reactivity between multiple viruses and risk ... ...

    Abstract Abstract Background Serum IgM (immunoglobulin M) testing is commonly used to diagnose acute viral infections. However, most clinicians are unaware of the vagaries of IgM testing, including antigenic cross-reactivity between multiple viruses and risk misdiagnosis. Case presentation We report a case of infectious mononucleosis with concomitantly positive IgM for EBV, CMV, VZV, and HSV. A 26-year-old man presented with acute infectious mononucleosis picture. His blood work showed a total bilirubin level of 7.7 mg/dl, ALT 1077 U/L, AST 806 U/L, ALP 325 U/L, and INR 1.0. Monospot was positive; peripheral blood smear showed atypical lymphocytes; however, because EBV infectious mononucleosis does not typically cause elevation of liver enzymes over 1000, other etiologies were explored. Tests for hepatitis A, B, C, HIV, ANA, and ASMA returned negative. IgM for EBV-VCA, CMV, HSV, and VZV all returned positive, and the diagnosis of EBV IM was called into question. Subsequent tests of CMV and HSV PCR for viral load were negative (VZV was not clinically suspected), and later on, EBV-EBNA returned negative and EBV-VCA IgM and IgG returned positive, confirming the diagnosis of acute EBV infection. Conclusion We believe that IgM seropositivity can result from cross-reactivity among several viruses (especially herpes viruses), and although often relied on, a positive IgM should not serve as the sole determinant for diagnosis of acute viral infections.
    Keywords False-positive ; False IgM ; Cross-reactivity ; Internal medicine ; RC31-1245
    Subject code 610
    Language English
    Publishing date 2020-09-01T00:00:00Z
    Publisher SpringerOpen
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Arterial Dissection in Antiphospholipid Syndrome Patients

    Kadhim Al-banaa / Alfarooq Alshaikhli / Asal AL-Hareeri / Mohammed Abdelhalim / Alsadiq Al-Hillan / Tejas Joshi

    European Journal of Case Reports in Internal Medicine (2021)

    Two Case Reports and a Literature Review

    2021  

    Abstract: Antiphospholipid syndrome (APS) is a multisystemic autoimmune disease which presents with thromboembolic disease, pregnancy complications and the presence of antiphospholipid antibodies. There are some reports of arterial dissections in different sites ... ...

    Abstract Antiphospholipid syndrome (APS) is a multisystemic autoimmune disease which presents with thromboembolic disease, pregnancy complications and the presence of antiphospholipid antibodies. There are some reports of arterial dissections in different sites of the body associated with APS. We describe two patients with APS who developed ischaemic stroke as a result of vertebral artery dissection in the absence of acquired and genetic risk factors for arterial dissection. We also conducted a systematic review of the literature for cases of arterial dissection associated with APS. We suspect that APS may be a potential cause of vasculopathy and arterial dissection. Further research is needed to explore this possible association.
    Keywords antiphospholipid antibody syndrome ; aps ; arterial dissection ; vasculopathy ; stroke mimic ; Medicine ; R
    Language English
    Publishing date 2021-05-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Low versus high dose anticoagulation in patients with Coronavirus 2019 pneumonia at the time of admission to critical care units

    Kadhim Al-Banaa / Abbas Alshami / Eiman Elhouderi / Sally Hannoodee / Maryam Hannoodee / Alsadiq Al-Hillan / Hussam Alhasson / Faisal Musa / Joseph Varon / Sharon Einav

    PLoS ONE, Vol 17, Iss 3, p e

    A multicenter retrospective cohort study in the Beaumont healthcare system.

    2022  Volume 0265966

    Abstract: Purpose Coagulopathy is common in patients with COVID-19. The ideal approach to anticoagulation remains under debate. There is a significant variability in existing protocols for anticoagulation, and these are mostly based on sporadic reports, small ... ...

    Abstract Purpose Coagulopathy is common in patients with COVID-19. The ideal approach to anticoagulation remains under debate. There is a significant variability in existing protocols for anticoagulation, and these are mostly based on sporadic reports, small studies, and expert opinion. Materials and methods This multicenter retrospective cohort study evaluated the association between anticoagulation dose and inpatient mortality among critically ill COVID-19 patients admitted to the intensive care units (ICUs) or step-down units (SDUs) of eight Beaumont Healthcare hospitals in Michigan, USA from March 10th to April 15th, 2020. Results Included were 578 patients with a median age of 64 years; among whom, 57.8% were males. Most patients (n = 447, 77.3%) received high dose and one in four (n = 131, 22.7%) received low dose anticoagulation. Overall mortality rate was 41.9% (n = 242). After adjusting for potential confounders (age, sex, race, BMI, ferritin level at hospital admission, intubation, comorbidities, mSOFA, and Padua score), administration of high anticoagulation doses at the time of ICU/SDU admission was associated with decreased inpatient mortality (OR 0.564, 95% CI 0.333-0.953, p = 0.032) compared to low dose. Conclusion Treatment with high dose anticoagulation at the time of ICU/SDU admission was associated with decreased adjusted mortality among critically ill adult patients with COVID-19.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616 ; 610
    Language English
    Publishing date 2022-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Liquid Presenting as Solid

    Varsha Gupta / Firas Ajam / Gabriella Conte / Alsadiq Al Hillan / Kadhim Al-Banaa / Vinit Singh / Michael Levitt

    European Journal of Case Reports in Internal Medicine (2020)

    A Rare Presentation of Acute Myeloid Leukaemia as a Solid Epidural Mass

    2020  

    Abstract: Myeloid sarcoma (MS) is a very rare malignant tumour composed of myeloblasts. It most commonly involves soft tissue, bone, periosteum and lymph nodes, but unusual presentation sites have also been reported. Typically, MS evolves concurrently with active ... ...

    Abstract Myeloid sarcoma (MS) is a very rare malignant tumour composed of myeloblasts. It most commonly involves soft tissue, bone, periosteum and lymph nodes, but unusual presentation sites have also been reported. Typically, MS evolves concurrently with active leukaemia or following remission, when it is known as secondary MS. But rarely MS can occur de novo without evidence of concomitant haematological disease. Herein, we report an unusual case of central nervous system-MS in a patient without evidence of concomitant haematological disease. In this case, progressive thoracic and lumbar pain with paraplegia ultimately led to the diagnosis of acute myeloid leukaemia. We also conducted a PubMed search for case reports, case series and reviews of past literature regarding central nervous system-MS and report our findings.
    Keywords central nervous system-myeloid sarcoma ; chloroma ; granulocytic sarcoma ; acute myeloid leukaemia ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2020-09-01T00:00:00Z
    Publisher SMC MEDIA SRL
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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