2.A Case of IgM Deficiency with B Cell Deficiency Detected by ABO Discrepancy in a Patient with Acute Osteomyelitis.
Chae Lim JUNG ; Mi Kyung CHA ; Byoung Hyuk JUN ; Ki Sook HONG
Annals of Laboratory Medicine 2013;33(3):208-211
ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics
;
Acute Disease
;
Adolescent
;
B-Lymphocytes/cytology/immunology/metabolism
;
Bone and Bones/radionuclide imaging
;
Genotype
;
Humans
;
Immunoglobulin A/blood
;
Immunoglobulin G/blood
;
Immunoglobulin M/blood
;
Immunologic Deficiency Syndromes/complications/*diagnosis
;
Knee/radionuclide imaging
;
Magnetic Resonance Imaging
;
Male
;
Osteomyelitis/complications/*diagnosis
;
Radiopharmaceuticals/diagnostic use
3.A Case of IgM Deficiency with B Cell Deficiency Detected by ABO Discrepancy in a Patient with Acute Osteomyelitis.
Chae Lim JUNG ; Mi Kyung CHA ; Byoung Hyuk JUN ; Ki Sook HONG
Annals of Laboratory Medicine 2013;33(3):208-211
ABO discrepancy refers to an inconsistency between red cell and serum typings and has various causes, including hypogammaglobulinemia. IgM deficiency is a rare disorder that may accompany several conditions such as infection and autoimmune disorders. Here, we describe a case of IgM deficiency discovered during the evaluation of an ABO discrepancy in a 16-yr-old Korean boy. ABO blood grouping showed that while his cell type was O+, serum typing detected only anti-A (3+). Anti-B was not detectable at room temperature but was graded at 1+ at 4degrees C. ABO genotyping revealed an O/O genotype. His serum IgG, IgA, and IgM concentrations were 770 mg/dL (reference range: 800-1,700 mg/dL), 244 mg/dL (reference range: 100-490 mg/dL), and 13.5 mg/dL (reference range: 50-320 mg/dL), respectively. He was diagnosed with acute osteomyelitis on the basis of clinical presentation and imaging studies. The symptoms gradually improved within 3 weeks of treatment. However, the ABO discrepancy and IgM deficiency persisted even 6 months after recovery and lymphocyte subset analysis revealed CD19+ B cell deficiency. To the best of our knowledge, IgM deficiency detected by ABO discrepancy in a patient with acute osteomyelitis has not been reported before.
ABO Blood-Group System/genetics
;
Acute Disease
;
Adolescent
;
B-Lymphocytes/cytology/immunology/metabolism
;
Bone and Bones/radionuclide imaging
;
Genotype
;
Humans
;
Immunoglobulin A/blood
;
Immunoglobulin G/blood
;
Immunoglobulin M/blood
;
Immunologic Deficiency Syndromes/complications/*diagnosis
;
Knee/radionuclide imaging
;
Magnetic Resonance Imaging
;
Male
;
Osteomyelitis/complications/*diagnosis
;
Radiopharmaceuticals/diagnostic use
4.The indication of bone scan for patients with newly diagnosed prostate cancer.
Dan LIU ; Wei WANG ; Lu-dong QIAO ; Yu-peng ZHENG ; Yue-xin LIU ; Guang-yin ZHANG ; Shan CHEN
Chinese Journal of Surgery 2012;50(5):443-445
OBJECTIVETo investigate the indication of bone scan for patients with newly diagnosed prostate cancer.
METHODSThe clinical data of continual 95 patients with newly diagnosed prostate cancer was involved between January 2006 and December 2010. The relationship between age, PSA, Gleason scores, clinical stage and positive bone scans was respectively compared.
RESULTSThe 33 patients (34.7%) with positive bone scans and 62 patients (65.3%) with negative bone scans. The mean age was (74±7) years and (76±7) years respectively in 2 groups respectively. PSA was (70.7±38.1) ng/ml and (28.4±27.2) ng/ml respectively, the difference was significant (t=-5.499, P=0.000). Clinical stage had positive correlation with positive bone scan, the OR value was 4.684. If the Gleason score>7, the sensitivity, specificity, positive predictive value and negative predictive value of positive bone scan was 64%, 63%, 48% and 77% respectively. If PSA>50 ng/ml, sensitivity, specificity, positive predictive value and negative predictive value was 67%, 86%, 71% and 83% respectively. If Clinical stage>T2, sensitivity, specificity, positive predictive value and negative predictive value was 82%, 81%, 69% and 89% respectively.
CONCLUSIONSFor patients with PSA≤10 ng/ml or simultaneously PSA≤50 ng/ml and Gleason score≤7 and clinical stage≤T2, bone scan is not necessary. Patients with newly diagnosed prostate cancer and PSA>50 ng/ml or Gleason score>7 or clinical stage>T2 should undergo bone scan.
Aged ; Aged, 80 and over ; Bone Neoplasms ; diagnostic imaging ; secondary ; Bone and Bones ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Radionuclide Imaging ; Retrospective Studies ; Sensitivity and Specificity
5.Inflammatory Polyarthritis in a Patient with Psoriasis: Is It Psoriatic Arthritis or Rheumatoid Arthrirtis?.
Kwang Hoon LEE ; Myoung Kyun SON ; You Jung HA ; Sang Tae CHOI ; Sang Won LEE ; Yong Beom PARK ; Soo Kon LEE
The Korean Journal of Internal Medicine 2010;25(2):224-226
Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. There are no generally accepted diagnostic criteria for PsA. Indeed, the diagnosis of this inflammatory arthritis is made by exclusion of other possible diseases and based upon immunologic, radiologic, and clinical features which are consistent with the diagnosis. Inflammatory arthritis in a patient with psoriasis can be an important clue for the diagnosis of PsA, but the possibility for diagnosis of other inflammatory arthritides ever remains. Herein we report a case of a female patient who was not diagnosed with PsA, but with rheumatoid arthritis, even though she had psoriasis.
Adult
;
Arthritis/classification/*diagnosis/*immunology
;
Arthritis, Psoriatic/classification/*diagnosis/*immunology
;
Bone and Bones/radiography/radionuclide imaging
;
Diagnosis, Differential
;
Female
;
Humans
;
Skin/pathology
6.Early evaluation of osteoarthritis using objective diagnostic methods.
China Journal of Orthopaedics and Traumatology 2009;22(5):402-404
Osteoarthritis (OA) is a chronic joint disease that involves degeneration of articular cartilage, limited intra-articular inflammation manifested by synovitis and changes in the subchondral bone. After the articular cartilage's stability and complex structure in the framework of pressure-proof were destruct, the ability to repair by itself was weak. Therefore early diagnosis in the treatment of osteoarthritis is a focal ponit. This paper addressed on the characteristics of diagnosis of OA in the relevant objective diagnostic methods.
Adult
;
Aged
;
Bone Density
;
physiology
;
Bone and Bones
;
diagnostic imaging
;
pathology
;
Calcification, Physiologic
;
Cartilage, Articular
;
diagnostic imaging
;
pathology
;
Female
;
Humans
;
Joints
;
diagnostic imaging
;
pathology
;
Magnetic Resonance Imaging
;
Male
;
Middle Aged
;
Osteoarthritis
;
diagnosis
;
epidemiology
;
Osteoarthritis, Knee
;
diagnosis
;
diagnostic imaging
;
Radiography
;
Radionuclide Imaging
;
Synovial Membrane
;
diagnostic imaging
;
pathology
;
Ultrasonography
7.Importance of diagnosis and research on bone and joint pathology.
Zhi-ming JIANG ; Hui-zhen ZHANG ; Li ZHENG
Chinese Journal of Pathology 2009;38(5):289-291
Arthrography
;
Bone Neoplasms
;
diagnosis
;
diagnostic imaging
;
pathology
;
Bone and Bones
;
diagnostic imaging
;
pathology
;
Diagnosis, Differential
;
Diagnostic Errors
;
Humans
;
Immunohistochemistry
;
Joint Diseases
;
diagnosis
;
diagnostic imaging
;
pathology
;
Joints
;
diagnostic imaging
;
pathology
;
Radionuclide Imaging
8.When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer?
Raj P PAL ; Thivyaan THIRUUDAIAN ; Masood A KHAN
Asian Journal of Andrology 2008;10(6):890-895
AIMSTo determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer.
METHODSBetween November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value.
RESULTSOnly 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups.
CONCLUSIONBased on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.
Aged ; Aged, 80 and over ; Analysis of Variance ; Bone Neoplasms ; diagnostic imaging ; secondary ; Bone and Bones ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Radionuclide Imaging ; Radiopharmaceuticals ; Retrospective Studies ; Technetium Tc 99m Medronate
9.The value of three-phase bone scintigraphy in the assessment of stress fractures.
Fetalvo Marlon V ; Magboo Vincent Peter C
The Philippine Journal of Nuclear Medicine 2008;3(1):9-13
Stress fractures are overuse injuries of the bones resulting from repetitive stresses. Since symptoms are non-specific, an imaging modality is mandatory for accurate diagnosis. Bone scintigraphy used to be the gold standard in evaluating stress fracture, but the advent of MRI led to its underutilization. This study aims to determine the role of three-phase bone scintigraphy in the assessment of stress fracture, and to determine the sensitivity, specificity, positive and negative predictive values and the accuracy rate of bone scan. In a tertiary hospital in Metro Manila, 15 patients referred for three-phase bone scintigraphy to assess for stress fracture from 2004 to 2006 were included in the study. Of these 15 patients, 12 also underwent MRI. Sensitivity, specificity, positive and negative predictive values, and the accuracy rate were computed with MRI as the gold standard. The sensitivity of bone scans approach 100 percent. However, its specificity is low due to other conditions that can produce a positive scan. Because of the limitations inherent to scintigraphy, MRI could be a valid first-line imaging technique in diagnosing stress fracture. MRI provides a greater anatomic detail of the area in question. It may secure an accurate diagnosis if the fracture line is demonstrated. However, extensive marrow edema precludes the visualization of the fracture line in some cases. Bone scintigraphy together with an accurate history is still a very useful tool in diagnosing stress fracture. MRI should be reserved for cases where the radiographic and scintigraphic findings are indeterminate.
Human ; Male ; Female ; Adult ; Bone Marrow ; Bone And Bones ; Cumulative Trauma Disorders ; Edema ; Fractures, Stress ; Magnetic Resonance Imaging ; Philippines ; Tertiary Care Centers ; Sensitivity And Specificity ; Radionuclide Imaging
10.Gastric Accumulation of Bone Seeking Agent in a Patient with Advanced Gastric Cancer.
Dae Weung KIM ; Hwan Jeong JEONG ; Soon Ah PARK ; Chang Guhn KIM
Journal of Korean Medical Science 2007;22(1):153-155
Soft tissue uptake of Tc-99m labeled bone seeking agents, such as Tc-99m 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD), is commonly seen in clinical practice, even though bone scintigraphy is mainly used to detect bone disease. However, gastric uptake of bone agents in patients with gastric cancer is very rare. And it has been reported that calcified gastric adenocarcinoma appears in only about 5% of all gastric cancer. We report a rare case of bone scintigraphy, single photon emission computed tomography and computed tomography fusion images that demonstrated diffuse gastric uptake of Tc-99m DPD in a patient with advanced gastric cancer.
Stomach Neoplasms/*metabolism
;
Stomach/*metabolism
;
Radiopharmaceuticals/*pharmacokinetics
;
Organotechnetium Compounds/diagnostic use/*pharmacokinetics
;
Male
;
Humans
;
Diphosphonates/diagnostic use/*pharmacokinetics
;
Bone and Bones/*radionuclide imaging
;
Aged

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