Panagiotis Andriopoulos

Reversal of heart failure in thalassemia major by combined chelation therapy: a case report

Abstract:  In patients with thalassemia major (TM) who are non‐compliant with long‐term desferrioxamine (DFO) chelation, survival is limited mainly because of cardiac complications of transfusional hemosiderosis. Combined chelation therapy with DFO and deferiprone has maximized the efficacy of the therapy and reduced cardiological complications. The aim of this report is to present the results of this combination in a desperate case of heart failure.

The patient with rhabdomyolysis: Have you considered quail poisoning?

THE CASES Patient 1: A 62-year-old woman was admitted with nausea, vomiting, weakness and leg muscle pain. The symptoms had begun 7 hours after a meal of fresh roasted quail. She was not taking any medications, had no allergies to food or medications and did not use alcohol, cigarettes or illicit

Transfusional hemosiderosis and combined chelation therapy in sickle thalassemia

Abstract:  Although the indications for transfusions in sickle cell syndromes are well listed, and chronic transfusion has become practicable since the recent advances in chelation therapy have essentially eliminated the risk of secondary iron overload, multi‐transfused, non‐compliant to long‐term chelation therapy patients confront the complication of iron overload and secondary hemosiderosis. In thalassemia major patients, combined therapy with desferrioxamine and deferiprone has maximized tissue iron removal and may reduce the overall occurrence of hemosiderotic heart failure. Despite this, safety and contradictions of chelating agents are still controversial. The aim of this report is to present the results of this combination in a long‐term transfused sickle β‐thalassemic patient suffering from severe heart failure and liver dysfunction.

Acute Abdomen due to Brucella melitensis

A case of acute abdomen caused by a Brucells melitensis is reported. The patient presented with biliary involvement in the form of acute acalculous cholecystitis and developed acute appendicitis that resulted in his surgical treatment.

Pregnancy in women with thalassemia: challenges and solutions.

Advances in treatment of thalassemia have led to the aging of thalassemic patients, and consequently concern about successful reproductive outcome is augmented. Although women with thalassemia intermedia only were considered competent of achieving pregnancy, case series reveal the willingness of both thalassemia major and thalassemia intermedia women to have a family. Pregnancy in general is characterized by dynamic multiple-system changes and increased susceptibility to oxidative stress, while homozygous, transfusion-dependent, β-thalassemia patients manifest cardiac, hepatic, endocrine, and metabolic disorders attributable to chronic anoxia and iron overload and thalassemia intermedia, usually nontransfused, is associated with augmented risk of thromboembolic events. Pregnancy in thalassemia should be considered a high risk for both mother and fetus, and favorable outcomes are the result of continuous preconception, antenatal, and postpartum assessment and management by a team of thalassemia experts.

Brucella Endocarditis as a Late Onset Complication of Brucellosis

Brucella endocarditis (BE) is a rare but life threatening complication of brucellosis. We present a case report of a patient with relapsing brucellosis complicated with aortic valve endocarditis. The patient underwent valve replacement and required prolonged antibiotic treatment because of rupture of the noncoronary leaflet and development of congestive heart failure. Since the onset of endocarditis in patients with brucellosis is not known, proper follow-up is required in order to identify any late onset complications, especially in endemic areas.

Molecular Diagnosis of Brucellosis: A Brief Report

Amplification of nucleic acid by polymerase chain reaction (PCR) assays in order to diagnose infection by Brucella spp. has been used for more than two decades. Human Brucellosis is an endemic disease in many countries worldwide and often poses diagnostic puzzles. The implementation of PCR (standard, real-time and multiplex) can help in the accurate differential diagnosis and distinguish between acute, subacute and chronic cases. PCR has also been used for follow up of patients and serotype identification of Brucella spp. Overall PCR is a promising and reliable technique for the diagnosis of Human Brucellosis. Purpose of this brief report is to identify possible alternatives for rapid and accurate diagnosis of Brucellosis using PCR.