#16
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àãðàíóëîöèòîç ñóäÿ ïî îïèñàíèåì â èíòåðíåòå íàäåæä íå âíóøàåò òàê ëè ?Òàê â îáùåì òî ÷òî ñ íåé? Èç-çà ÷åãî òåìïåðàòóðà è òàêèå àíàëèçû? ×òî åùå ìîæíî ïðåäïðèíÿòü? (àíàëèçû, ëå÷åíèå)
åùå áûëî íàçíà÷åíî ìåòèëóðàöèë è ôîëèâàÿ êèñëîòà èõ òîæå íå ïèòü? |
#17
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åùå ãîòîâ îäèí àíàëèç
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#18
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Âñå ñîîáðàæåíèÿ/ðåêîìåíäàöèè, êîòîðûå ìîæíî äàòü çàî÷íî, óæå èçëîæèë âûøå; ëåêàðñòâåííûé àãðàíóëîöèòîç ïðè íàçíà÷åíèè Ã-ÊÑÔ â 90-95% ñëó÷àåâ îáðàòèì/èçëå÷èì.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#19
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ñäåëàëè áèîïñèþ êîñòíîãî ìîçãà ðåçóëüòàòû âûëîæó ñåãîäíÿ ïîçæå. Èñêëþ÷èëè îíêîçàáîëåâàíèå. è ïîñåâ áóäåò ãîòîâ â ÷åòâåðã. Ñåãîäíÿ íàçíà÷àò ëå÷åíèå ãåìàòîëîã. ×òî íàçíà÷èò íàïèøó. Íå ñèëüíî ïðèñëóøèâàþòñÿ ê âàøèì ñîâåòàì. ( äàæå ñëóøàòü íå õîòÿò )
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#20
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ìîæåò îíè ïðèñëóøàþòñÿ ê çàðóáåæíûì ïóáëèêàöèÿì (åñëè Âû èì èõ ïåðåâåäåòå?):
J Korean Pediatr Soc. 1999 Dec;42(12):1725-1729. Korean. A Case of Acute Drug-Induced Agranulocytosis Treated with Recombinant Granulocyte Colony-Stimulating Factor(G-CSF). Lee YJ, Lee KY, Cha SW, Han JW, Whang KT, Kim HJ. Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea. Department of Clinical Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea. Abstract Drug-induced agranulocytosis is a potentially lethal disorder characterized by selective neutropenia. G-CSF has been utilized for its treatment. We report a case of acute agranulocytosis probably associated with injection of sulpyrine(dipyrone). A three-year old girl was admitted to Taejon St. Mary's Hospital following five days of fever and two days of chills and prostration. During this period, she had been treated at local clinics with oral acetaminophen, ibuprofen, and miokamycin. Two days before admission, she was administered an intramuscular injection of dipyrone as antipyretics. She had a past history of previous sensitization of dipyrone. CBC revealed profound netropenia(total WBC 900/mm3, with 1% neutrophils, 88% lymphocytes, 10% atypical lymphocytes, 1% monocytes), but normal RBC and platelet count. Bone marrow examination showed hypocellularity(20%), decreased myeloid precusors, and M:E ratio of 1 : 2.5. The girl received subcutaneous G-CSF once daily for 3 days. G-CSF therapy resulted in a steep increase of neutrophil count, which was faster than the spontaneous recovery reported in the literature. G-CSF may be considered useful in the management of drug-induced agranulocytosis. --- èëè Nonchemotherapy drug-induced agranulocytosis: interest of haematopoietic growth factors [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] èëè ïóñòü îòêðîþò ëþáóþ ñîâðåìåííóþ êíèæêó ïî ãåìàòîëîãèè - ðàçäåë ëå÷åíèå àãðàíóëîöèòîçà.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#21
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Äîáðûé äåíü!
Â÷åðà áûëà âçÿòà áèîïñèÿ êîñòíîãî ìîçãà. ß ðàçãîâàðèâàë ñ çàâåäóþùåé îòäåëåíèÿ ãåìàòîëîãèè. Íà ÷òî îíà ìíå îòâåòèëà ÷òî èñêëþ÷àåò àãðàíóëîöèòîç, ëåéêîç, ó íåå ëåéêîïåìèÿ è âñå áðîñèëà òðóáêó. Òàê ëè ýòî? Àíàëèç íå äàþò ñôîòîãðàôèðîâàòü ñêàçàëà æåíà ñêàçàëè íåëüçÿ, ïîïðîñèëè ìåäñåñòðó êîòîðàÿ ñôîòîãðàôèðîâàëà íî íå ÷åòêî. Ðàçâå ýòî ìîæåò áûòü ñåêðåòîì ? Âå÷åðîì íà÷àëè êîëîòü àíòèáèîòèê ëèíêîìèöèí. ß ïîñìîòðåë îïèñàíèå ïðåïàðàòà â ïîáî÷íûõ äåéñòâèÿõ íàïèñàíî ñëåäóþùåå: Ñî ñòîðîíû ñèñòåìû êðîâåòâîðåíèÿ: íåéòðîïåíèÿ, òðîìáîöèòîïåíèÿ, àãðàíóëîöèòîç, ïàíöèòîïåíèÿ. P/S ôîòî íåäîñòàòî÷íîãî êà÷åñòâà åñëè íå ïîíÿòíî ïîñòàðàþñü êàê íè áóäü âçÿòü êîïèþ ( åñëè ïîëó÷èòñÿ ). Ïðè÷èíó äî ñèõ ïîð íå âûÿâèëè. Ãåìàòîëîã ïðîïèñàë äëÿ ñíÿòèÿ òåìïåðàòóðû êåòàðîë. |
#22
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Âðîäå òóò ïîëó÷øå.
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#23
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Íåéòðîïåíèÿ - ÷èñëî íåéòðîôèëîâ ìåíåå 1500; àãðàíóëîöèòîç - ìåíåå 500, â àíàëèçå îò 31.01 àáñ. ÷èñëî íåéòðîôèëîâ 1600õ0.03=48, ìíå èñêðåííå æàëü, ÷òî íà ìåñòå ãåì. îòäåëåíèåì ðóêîâîäÿò òàêèå "ñïåöèàëèñòû"
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#24
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à ìèåëîãðàììà ýòî òîæå ïîäòâåðæäàåò?
îíà áûëà ñäåëàíà ïîçæå 02.02.15 |
#25
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â ìèåëîãðàììå íè÷åãî íåò ïðèìå÷àòåëüíîãî, íî åå ðåçóëüòàòû ñëåäóåò èíòåðïðåòîðîâàòü ñ îñòîðîæíîñòüþ: îòñóòñòâèå ÿâíîãî ãèïåðîòâåòà â ÊÌ íà ôîíå ñèëüíîé íåéòðîïåíèè ìîæåò ãîâîðèòü, ÷òî ÊÌ ðàáîòàåò íåàäåêâàòíî (íåò àäåêâàòíîãî îòâåòà íà öèòîïåíèþ) è ïîäòâåðæäàòü åãî îòíîñèòåëüíîå óãíåòåíèå àíàëüãèíîì èëè åøå êàêèì ëåêàðñòâîì.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#26
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âû íàñòàèâàåòå íà ïðèåìå íåéïîãåíà? ÊÀÊ ÌÍÅ óáåäèòü âðà÷à?
Òåì áîëåå îíà ëåæèò â ïðîñòîé êëèíèêå à íå â ãåìîòîëîãèè, åå íå ïîëîæèëè òóäà íå ïîñ÷èòàëè íóæíûì((((( ×ÒÎ ÄÅËÀÒÜ??? |
#27
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Ìîæíî íà ÷åì-òî íàñòàèâàòü, åñëè ÷åëîâåê íàõîäèòñÿ äîìà è ìîæåò ïðèíèìàòü òî èëè èíîå ëåêàðñòâî â òàáëåòêàõ, â äîìàøíèõ óñëîâèÿõ ñëîæíî äàæå ðåêîìåíäîâàòü çàî÷íî ÷òî-ëèáî â/â, èáî íóæåí ñïåöèàëèñò íà ìåñòå. Òðåáîâàòü îïðåäåëåííîå ëåêàðñòâî äëÿ ñóïðóãè â óñëîâèÿõ ñòàöèîíàðà ðàâíîñèëüíî òðåáîâàíèÿì 5-è ðàçîâîãî äèåò. ïèòàíèÿ ïëþñ äðóãèå ñàí-êóð. áëàãà äëÿ ÷åëîâåêà èç-çà ÿçâû â àíàìíåçå, íàõîäÿùåìñÿ â ÑÈÇÎ.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#28
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Íó êàê ÿ ïîíèìàþ íà òåêóùåì óðîâíå òîæå íåëüçÿ îñòàâëÿòü...
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#29
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ðàñïå÷àòàþ íàøó ïåðåïèñêó îòíåñó ãë. âðà÷ó, ïóñòü ïðèìèíàþò ìåðû. (íåéïîãåí ïðèîáðåòó êîíå÷íî ñàìîñòîÿòåëüíî )
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#30
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Âîò åùå îäíà ñòàòüÿ, îïóáë. â 2014 ãîäó â ïîëíîé âåðñèè:
Should be or Not Use Haematopoietic Growth Factors in the Case of Drug-induced Agranulocytosis [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |