Kala Gnanasekaran Kiruthiga , Sarita Verma Kokane , Kannan Subramanian , Avinash Pradhan , Ravi Godbole
{"title":"Juvenile myelomonocytic leukemia masquerading as Langerhans cell histiocytosis: An immuno-morphologic dilemma","authors":"Kala Gnanasekaran Kiruthiga , Sarita Verma Kokane , Kannan Subramanian , Avinash Pradhan , Ravi Godbole","doi":"10.1016/j.phoj.2024.09.002","DOIUrl":"10.1016/j.phoj.2024.09.002","url":null,"abstract":"<div><h3>Background</h3><p>Non-neoplastic, reactive proliferation of Langerhans cells is observed in leukemias, pseudo-lymphomas, carcinomas, etc. Juvenile myelomonocytic leukemia (JMML) is a rare myelodysplastic/myeloproliferative neoplasm with a few overlapping clinical features to Langerhans cell histiocytosis (LCH). JMML involving the lymph nodes may show the proliferation of Langerhans cells.</p></div><div><h3>Case report</h3><p>A two year old boy presented with fever, hepatosplenomegaly and elevated total leukocyte count with monocytosis. Bone marrow revealed dysplasia in erythroids and myeloids. Axillary lymph node showed sheets of macrophages in sinuses and paracortical areas (S100, CD68 and CD 1a positive) admixed with eosinophils, mimicking LCH. Molecular analysis revealed somatic heterozygous, missense mutation in PTPN11 exon 3, a known pathogenic hot spot mutation in JMML.</p></div><div><h3>Conclusion</h3><p>The treatment and prognosis of JMML and LCH are different. JMML may have a clinical and morphological overlap with LCH and hence can be misdiagnosed. This paper highlights the similarities and differences between the two diseases with a case illustration.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 267-270"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000767/pdfft?md5=43f40bbf610c4051192f16e37e3244aa&pid=1-s2.0-S2468124524000767-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dhaarani Jayaraman , Harshavardhan Mahalingam , Naga Geetha Rani Mangam , Swati Narasimhan , Padmasani Venkat Ramanan , K. Stephen Sudhakar , Prasanna Kumar S , Banu Keerthana , Manu Vidhya Harikumar , Anupama Jyoti Kindo , T.K. Shruthi , Niranjan Ragavan , Julius Xavier Scott
{"title":"Mucor thriving on iron in beta thalassemia major: A case of rhino-orbital mucormycosis","authors":"Dhaarani Jayaraman , Harshavardhan Mahalingam , Naga Geetha Rani Mangam , Swati Narasimhan , Padmasani Venkat Ramanan , K. Stephen Sudhakar , Prasanna Kumar S , Banu Keerthana , Manu Vidhya Harikumar , Anupama Jyoti Kindo , T.K. Shruthi , Niranjan Ragavan , Julius Xavier Scott","doi":"10.1016/j.phoj.2024.09.003","DOIUrl":"10.1016/j.phoj.2024.09.003","url":null,"abstract":"<div><p>Mucormycosis is a dreaded condition with high mortality rates noted in immunocompromised hosts. Though iron overload is a known risk factor, children with transfusion-dependent thalassemia have been rarely reported with invasive mucormycosis. We present an 8-year-old girl with transfusion-dependent thalassemia with hypersplenism and iron overload. She had invasive rhino-sino-orbital mucormycosis with a fatal outcome despite aggressive surgical and medical management.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 271-273"},"PeriodicalIF":0.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000743/pdfft?md5=730979c1a3f034f0f6573ada92f56611&pid=1-s2.0-S2468124524000743-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prenatally detected adrenal immature teratoma: A case report and review of literature","authors":"Nishkala Rao , Amrit Kaur , Arunkumar A.R. , Prakruthi S.K. , Vinay Jadhav , Suma M.N.","doi":"10.1016/j.phoj.2024.08.004","DOIUrl":"10.1016/j.phoj.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><p>Teratomas are germ cell tumors derived from totipotent cells, with presentation outside the gonads being rare, and adrenal location being even rarer. Prenatally detected adrenal teratomas are extremely uncommon.</p></div><div><h3>Case report</h3><p>We report a rare case of a 5-month-old girl with a prenatally detected left suprarenal mass, which was initially suspected to be a congenital neuroblastoma. Abdominal computed tomography showed a cystic lesion measuring 7.9 x 8.8 × 11.5 cm in the left suprarenal region compatible with adrenal teratoma. The infant underwent laparotomy with excision of the lesion. The histopathological diagnosis was cystic immature teratoma.</p></div><div><h3>Conclusion</h3><p>Although adrenal teratoma is extremely rare, it should be included in the clinical and radiologic differential diagnosis of prenatally detected suprarenal masses.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 279-282"},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000731/pdfft?md5=53b01dc0d97f8eb4bed00a71446339d3&pid=1-s2.0-S2468124524000731-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unmasking Evans syndrome: A rare presentation of Schimke immune-osseous dysplasia","authors":"Swathi Krishna, Purva Kanvinde, Ritika Khurana, Minnie Bodhanwala, Sangeeta Mudaliar","doi":"10.1016/j.phoj.2024.08.003","DOIUrl":"10.1016/j.phoj.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><p>Evans syndrome is an autoimmune condition that manifests as two or more autoimmune cytopenia. We present a case of Evans syndrome diagnosed with an underlying skeletal dysplasia; Schimke immune-osseous dysplasia (SIOD). The condition is characterized by spondyloepiphyseal dysplasia, progressive nephropathy, and T-cell immunodeficiency with cytopenia. Notably, our patient did not exhibit any signs of renal involvement.</p></div><div><h3>Case report</h3><p>A five-and-a-half-year-old female child presented with a short history of bleeding manifestations along with a history of poor weight and height gain. She was subsequently diagnosed with Evans syndrome secondary to an underlying SMARCAL1 mutation, which could be well controlled with oral steroids.</p></div><div><h3>Conclusion</h3><p>SIOD is a rare multisystem disorder affecting the skeletal, renal, immune, and vascular systems. Autoimmune cytopenia was the chief presentation of our patient. Such entities should be suspected in patients with growth failure, bone deformities, and hematological involvement. Early genetic testing will help to reduce disease-related comorbidities and aid in rationalizing treatment strategies.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 250-254"},"PeriodicalIF":0.0,"publicationDate":"2024-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000652/pdfft?md5=329bfa59485f181b7f3426969d2b1d7d&pid=1-s2.0-S2468124524000652-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Autoimmune hemolytic anemia in children","authors":"Dinesh Chandra , Varun Capoor , Ayoniza Maitri , Rahul Naithani","doi":"10.1016/j.phoj.2024.08.002","DOIUrl":"10.1016/j.phoj.2024.08.002","url":null,"abstract":"<div><p>Autoimmune hemolytic anaemia (AIHA) is an uncommon cause of antibody-induced hemolytic anemia in children. It is divided into three categories: warm AIHA, cold antibody AIHA and paroxysmal cold hemoglobinuria. The diagnostic work-up typically begins with a peripheral smear and a direct antiglobulin test. Further diagnostic approaches and pathogenesis of all three entities are discussed. Clinical trials are lacking for AIHA in children. First-line therapy for warm AIHA is corticosteroids and for cold antibody AIHA is rituximab. Data on other therapeutic agents is reviewed. Supportive care is an important aspect, particularly in cold AIHA and paroxysmal cold hemoglobinuria. Issues related to blood transfusion due to antibodies including the least incompatible blood are discussed. Tables and figures provide an overview of pathology, diagnosis and diagnostic algorithm.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 255-264"},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000640/pdfft?md5=b8c73190f8308a49ebba5d1c6a8f475b&pid=1-s2.0-S2468124524000640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Unusual cause of haemolytic anaemia: Glucose phosphate isomerase deficiency","authors":"Mukesh Dhankar, Piali Mandal, Robin Singh","doi":"10.1016/j.phoj.2024.08.001","DOIUrl":"10.1016/j.phoj.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Glucose phosphate isomerase (GPI) deficiency is a rare autosomal recessive disorder that causes hereditary nonspherocytic hemolytic anemia (HNSHA). It is caused by homozygous or compound heterozygous mutation of the GPI gene on chromosome 19q13. Approximately 57 GPI mutations have been reported at the molecular level.</p></div><div><h3>Case report</h3><p>A 4-years and 6-month-old boy presented with progressive pallor along with multiple blood transfusion requirements since four months of age. He had hemolytic anemia associated with macrocytosis, reticulocytosis, neutropenia, and hyperbilirubinemia. Whole-exome sequencing showed that he carried a specific variant in the GPI gene, denoted as c.1040G > A p.Arg347His, which is a homozygous autosomal recessive inherited pathogenic mutation found in exon 12.</p></div><div><h3>Conclusion</h3><p>This report highlights the clinical features and molecular etiology of an Indian patient with GPI deficiency, a rare cause of hereditary hemolytic anemia. A specific variant in the GPI gene was identified through whole-exome sequencing, which is linked to HNSHA. Patients with GPI deficiency require medical management during childhood to monitor for potential complications and prevent hemolytic crises. With optimal management, patients with GPI deficiency can lead a relatively healthy life with normal expectations of growth and development.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 283-286"},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000639/pdfft?md5=fb06472d52e70f8c690372f8d883447d&pid=1-s2.0-S2468124524000639-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Autosomal dominant multicentric infantile myofibromatosis: A case report","authors":"Jessica Justus Kurian, Megan R. Lyle","doi":"10.1016/j.phoj.2024.07.007","DOIUrl":"10.1016/j.phoj.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><p>Infantile myofibromatosis (IM) is a rare disorder of benign fibrous tumors, where severity and prognosis depend on the location of tumors, particularly if visceral organs are affected. Most cases of IM are sporadic. However, some familial cases of multicentric IM have been reported, primarily involving genes <em>PDGFRB</em> and <em>NOTCH3</em>.</p></div><div><h3>Case report</h3><p>We describe the clinical features and clinical course of two African American siblings with autosomal dominant multicentric IM caused by a novel mutation in the platelet-derived growth factor receptor β (<em>PDGFRB</em>) gene, c.1679C > T, resulting in p.Pro560Leu. This mutation was inherited from their mother, who was an asymptomatic carrier.</p></div><div><h3>Conclusion</h3><p>The <em>PDGFRB</em> gene mutation, c.1679C > T, is a novel mutation that causes multicentric IM with an autosomal dominant inheritance pattern. It is difficult to determine whether chemotherapy regimens are effective or whether tumor development and recession proceed along their natural course despite medical intervention.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 231-234"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000627/pdfft?md5=7eeff7e765809b5297309cd0b8a33079&pid=1-s2.0-S2468124524000627-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141985161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sri Lakshmi Jamalapur , Alexander K. Glaros , Yaddanapudi Ravindranath
{"title":"Voxelotor (GBT440) in pediatric sickle cell disease: A review","authors":"Sri Lakshmi Jamalapur , Alexander K. Glaros , Yaddanapudi Ravindranath","doi":"10.1016/j.phoj.2024.07.006","DOIUrl":"10.1016/j.phoj.2024.07.006","url":null,"abstract":"<div><p>Sickle cell disease (SCD) was first described in 1910 in African Americans, and the mutant hemoglobin S (HbS) was identified by electrophoresis in 1948. Sickle cell disease is the first genetic disease to be molecularly defined - a single point mutation in the β-globin gene (GAG→GTG) results in substitution of valine for glutamic acid at amino acid residue 7 (including the starting methionine). Pharmacological intervention to correct the defect at a molecular/protein level has proven complex. The only established curative therapy is hematopoietic stem cell transplantation, with recent gene therapy approvals providing hope for the same. Herein, we discuss voxelotor, a drug designed to reverse the hemoglobin polymerization defect caused by the β7Glu > Val substitution in the hemoglobin molecule.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 244-249"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000615/pdfft?md5=163222d9d19982400dd9ad3c5544cafe&pid=1-s2.0-S2468124524000615-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Homozygous hemoglobin Lepore disease in a child: A case report","authors":"Rimjhim Sonowal , Aditi Das , Atanu Kumar Dutta , Nihar Ranjan Mishra","doi":"10.1016/j.phoj.2024.07.005","DOIUrl":"10.1016/j.phoj.2024.07.005","url":null,"abstract":"<div><h3>Background</h3><p>Hemoglobin Lepore is a rare variant of structurally abnormal hemoglobin. Homozygous hemoglobin Lepore is even more rare.</p></div><div><h3>Case report</h3><p>We describe a case of homozygous hemoglobin Lepore in a 4-year 8-month-old boy. He presented with a thalassemia intermedia-like presentation. His diagnosis was confirmed by family screening with high-performance liquid chromatography (HPLC) and genetic testing.</p></div><div><h3>Conclusion</h3><p>Homozygous hemoglobin Lepore can present as thalassemia intermedia. It can be a diagnostic dilemma if only patient's HPLC is reported. Genetic testing and family screening aid to identify and confirm this uncommon variant of hemoglobin.</p></div>","PeriodicalId":101004,"journal":{"name":"Pediatric Hematology Oncology Journal","volume":"9 4","pages":"Pages 219-222"},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468124524000603/pdfft?md5=1a40fd5d2d1c2b285d296dae0c25bec3&pid=1-s2.0-S2468124524000603-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}