Re: Phlebotomy alternative to Hydroxychloroquine?

Quoted message said:

Quoted message said:

On Mar 23, 12:15 pm, "[email hidden]" <[email hidden]> wrote:

..
The prefer to allow them all to .. die .. slowly ..
<<

This drug is .. **specifically** .. used to lower red blood cell
count .. http://tinyurl.com/3ddkzy .. erythrocytosis .. which can be
treated by .. lowering of red blood cell count .. and this has and
always has been treated by blood donation / venesection / phlebotomy /
bloodletting .. but it seems in this girl .. they didn't .. bother ..

Titre du document / Document title
Sickle cell anemia with systemic lupus erythematosus : Response to
hydroxyurea therapy
Auteur(s) / Author(s)
SHETTY A. K. (1) ; RAJEEV KUMAR S. (2) ; GEDALIA A. (3) ; WARRIER R.
P. (2) ;
Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)
(1) Clinical Pediatrics, Department of Pediatrics, Louisiana State
University Medical Center and Children's Hospital of New Orleans, New
Orleans, Louisiana, ETATS-UNIS
(2) Pediatric Hematology/Oncology, Department of Pediatrics, Louisiana
State University Medical Center and Children's Hospital of New
Orleans, New Orleans, Louisiana, ETATS-UNIS
(3) Pediatric Rheumatology, Department of Pediatrics, Louisiana State
University Medical Center and Children's Hospital of New Orleans, New
Orleans, Louisiana, ETATS-UNIS

Résumé / Abstract
Purpose: To report the efficacy of hydroxyurea (HU) in a patient with
sickle cell anemia (SCA) associated with systemic ]upus erythematosus
(SLE). Patients and Methods: An unusual association of SCA with SLE
occurred in a 14-year-old black girl. Her medical history was
significant for repeated vasoocclusive crises requiring repeated
hospitalizations and transfusions, acute chest syndrome,
hyperhemolytic crises, multiple transfusions resulting in iron
overload, gall stones, avascular necrosis, and significant
psychosocial problems. Her lupus activity was controlled with oral
prednisone and hydroxychloroquine. Treatment with oral HU was
instituted at an initial dose of 20 mg/kg with gradual increment to a
maximum of 25 mg/kg daily. Results: A dramatic clinical improvement
was noted with HU therapy with no episode of pain crisis or
hospitalization for 5 months. There was an increase in fetal
hemoglobin (HbF) to 20.9% and mean corpuscular volume to 114.5 fl, but
her Hb level remained steady at 7.5 g/dl. No toxicity was noted with
HU therapy. In addition, a significant change was also observed in her
school performance, social activities, and general quality of life.
Conclusions: HU therapy may be beneficial and safe and should be
considered for other patients who have SCA with SLE.
Revue / Journal Title
Journal of pediatric hematology/oncology (J. pediatr. hematol./
oncol.) ISSN 1077-4114 CODEN JPHOFG
Source / Source
1998, vol. 20, no4, pp. 335-337 (14 ref.)
Langue / Language
Anglais

Editeur / Publisher
Lippincott, Hagerstown, MD, ETATS-UNIS (1995) (Revue)

Mots-clés anglais / English Keywords
Sickle cell anemia ; Lupus erythematosus ; Disseminated ; Concomitant
disease ; Hydroxycarbamide ; Treatment ; Case study ; Treatment
efficiency ; Child ; Female ; Human ; Hemopathy ; Hemolytic anemia ;
Hemoglobinopathy ; Genetic disease ; Skin disease ; Connective tissue
disease ; Systemic disease ; Autoimmune disease ; Immunopathology ;
Mots-clés français / French Keywords
Anémie hématie falciforme ; Lupus érythémateux ; Disséminé ;
Association morbide ; Hydroxycarbamide ; Traitement ; Etude cas ;
Efficacité traitement ; Enfant ; Femelle ; Homme ; Hémopathie ; Anémie
hémolytique ; Hémoglobinopathie ; Maladie héréditaire ; Peau
pathologie ; Tissu conjonctif pathologie ; Maladie système ; Maladie
autoimmune ; Immunopathologie ;

002b02g ;
Mots-clés espagnols / Spanish Keywords
Anemia glóbulo falciforme ; Lupus eritematoso ; Diseminado ;
Asociación morbosa ; Hidroxicarbamida ; Tratamiento ; Estudio caso ;
Eficacia tratamiento ; Niño ; Hembra ; Hombre ; Hemopatía ; Anemia
hemolítica ; Hemoglobinopatía ; Enfermedad hereditaria ; Piel
patología ; Tejido conjuntivo patología ; Enfermedad sistémica ;
Enfermedad autoinmune ; Inmunopatología ;
Localisation / Location
INIST-CNRS, Cote INIST : 18320, 35400007286553.0090

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Tom

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Quoted message said:

Arch Pediatr
2000 Mar;7(3):249-55
[Prevention of sickle cell crises with multiple phlebotomies].
[Article in French]
Bouchair N, Manigne P, Kanfer A, Raphalen P, de Montalembert M,
Hagege
I, Verschuur A, Maier-Redelsperger M, Girot R
Service de pediatrie, CHU,
Constantine, Algerie.

OBJECTIVES:
Sickle cell disease patients suffering from frequent painful crises
were submitted to phlebotomies in order to reduce hospitalization
days
due to pain, through hemoglobin (Hb) level reduction and iron
deficiency in patients with an hemoglobin level equal to or above 9.5
g/dL.

PATIENTS:
Seven sickle cell disease patients (four SC, three SS), aged four to
24
years, were submitted to sequential phlebotomies during periods from
18
months to four years.

METHODS:
The number of hospitalization days for crises was considered.
The volumes and frequencies of phlebotomies were adjusted according
to
the patients ages, the hemoglobin concentrations and the serum
ferritin
levels.

RESULTS:
One hundred and forty-four hospitalization days were recorded in the
seven patients in the year preceding the treatment.
During the study period, the annual numbers of hospitalization days
were respectively 20, five, six and one.
Mean hemoglobin concentration was 10.7 g/dL before phlebotomies and
8.8
to 9.2 g/dL during the four years of treatment.
Mean corpuscular volume, mean corpuscular hemoglobin concentration
and
serum ferritin were also reduced.
The volume of phlebotomies was 116 to 39 mL/kg/year according to the
patients.
COMMENTS AND CONCLUSION:
The striking decrease of the number of hospitalization days for all
the
patients suggests a closed relationship between therapy and clinical
improvement.
The mechanism of this effect is probably multifactorial:
a) the concentration of Hb level is known to influence the blood
viscosity and its decrease always improved rheology in sickle cell
disease patients;
b) the mean corpuscular hemoglobin concentration is a critical factor
concerning the HbS molecule polymerization in sickle cell disease,
and
its slight reduction may have an important biological effect.
We observed these two biological modifications in our patients and
suggest that they mediate the clinical effects.
The iron deficiency induced by phlebotomies has no evident
deleterious
consequence either on height and weight in the children or on
intellectual performance in any patients.

Publication Types: * Clinical trial
PMID: 10761600, UI: 20224666

Who loves ya.
Tom

Jesus Was A Vegetarian!http://jesuswasavegetarian.7h.com

Man Is A Herbivore!http://tinyurl.com/a3cc3

DEAD PEOPLE WALKINGhttp://tinyurl.com/zk9fk