Document 0182
 DOCN  M9460182
 TI    Disseminated Mycobacterium avium-intracellulare infection in a patient
       with myelodysplastic syndrome (refractory anemia).
 DT    9408
 AU    Tsukada H; Chou T; Ishizuka Y; Ogawa O; Saeki T; Ito S; Wakabayashi M;
       Hayashi N; Arakawa M; Department of Medicine (II), Niigata University
       Medical School,; Japan.
 SO    Am J Hematol. 1994 Apr;45(4):325-9. Unique Identifier : AIDSLINE
       MED/94234124
 AB    A 31-year-old woman presented with fever and arthralgia. Despite
       treatment with antimicrobials and corticosteroids, her symptoms
       persisted. A diagnosis of myelodysplastic syndrome (MDS)-refractory
       anemia (RA) was made by pancytopenia, dysplasia, and trisomy 8. Cultures
       of bone marrow, blood, and gastric juice showed Mycobacterium
       avium-intracellulare (MAI). She was treated with antimycobacterial drugs
       and recombinant human G-CSF/M-CSF and showed an initial response, but
       spike fever recurred and pancytopenia progressed. Hepatosplenomegaly and
       marked retroperitoneal lymphadenopathy were revealed, indicating further
       dissemination of MAI. Treatment with recombinant human GM-CSF and
       very-low-dose cytosine arabinoside, was started but was not effective.
       This case showed significant reduction in peripheral blood
       T-lymphocytes, especially the CD4+ population, and low immunoglobulin
       levels. Immunodeficiency state associated with long-term steroid therapy
       and MDS seemed to contribute to the development of the disseminated
       infection with MAI.
 DE    Adult  Anemia, Refractory/*COMPLICATIONS/DRUG THERAPY/MICROBIOLOGY
       Antigens, CD4/ANALYSIS  AIDS-Related Opportunistic Infections/IMMUNOLOGY
       Bone Marrow/MICROBIOLOGY  Case Report  Cytarabine/THERAPEUTIC USE
       Dose-Response Relationship, Drug  Female  Gastric Juice/MICROBIOLOGY
       Granulocyte-Macrophage Colony-Stimulating Factor/BLOOD/  THERAPEUTIC USE
       Human  Macrophage Colony-Stimulating Factor/THERAPEUTIC USE
       Mycobacterium avium-intracellulare Infection/*COMPLICATIONS/DRUG
       THERAPY/IMMUNOLOGY  Myelodysplastic Syndromes/*COMPLICATIONS/DRUG
       THERAPY/  MICROBIOLOGY  Recombinant Proteins/THERAPEUTIC USE
       T-Lymphocytes/IMMUNOLOGY/PATHOLOGY  Time Factors  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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