The American journal of pediatric hematology/oncology
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Am J Pediatr Hematol Oncol · Jan 1987
Case ReportsManagement of human immunodeficiency virus-associated thrombocytopenia with intravenous gamma globulin.
A 17-month-old boy in whom immune-mediated thrombocytopenia (ITP) was the presenting manifestation of infection with human immunodeficiency virus (HIV) is being successfully managed with intermittent high-dose intravenous gamma globulin (IVIG) allowing maintenance of hemostatic platelet counts while avoiding the immunosuppression associated with other therapeutic modalities used to treat ITP. He continues to demonstrate marked responsiveness to IVIG, and has been maintained on weekly or bimonthly infusions for 12 months. The serendipitous documentation of HIV infection prior to IVIG therapy for immune-mediated thrombocytopenia in this child documents the importance of HIV testing prior to IVIG therapy to prevent erroneous assignment of IVIG as the vehicle responsible for transmission of HIV infection. This case history also documents the importance of HIV testing in the diagnostic evaluation of immune-mediated thrombocytopenias.
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Am J Pediatr Hematol Oncol · Jan 1987
Congenital and neonatal malignant tumors. A 28-year experience at Children's Hospital of Los Angeles.
Fifty-one cases of congenital and neonatal malignant tumors were collected from the Children's Hospital of Los Angeles Department of Pathology files and reviewed. The study covered a 28-year period, 1958-1985. ⋯ Moreover, the response to therapy was also dissimilar. Leukemia and neuroblastoma were the most frequent malignancies and were responsible also for the largest number of deaths.
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Am J Pediatr Hematol Oncol · Jan 1984
Blood component transfusion in the intensive care nursery. Indications and special problems.
Increasingly, transfusions of component blood products are used in the setting of the neonatal intensive care unit. There is a need to analyze the indications and potential complications of this therapy critically. ⋯ Specifically, we discuss the rationale, indications and complications of red cell, granulocyte, and platelet transfusions in these patients. Discussion of exchange transfusion and the particular blood banking requirements of these patients will be reviewed in subsequent articles.
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The problem of postsplenectomy sepsis in children who have had splenectomy secondary to trauma is reviewed. Alternatives to splenectomy should be considered when appropriate. Pneumococcal vaccination and the use of prophylactic antibiotics are necessary if splenectomy is unavoidable.
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Am J Pediatr Hematol Oncol · Jan 1983
Overview of humanistic progress in sickle cell anemia during the past 10 years.
Humanistic progress in sickle cell anemia over the past 10 years is described, with a focus on individual, institutional, and societal progress. Accessibility, acceptability, and accountability are examined for humanistic progress in medical care, counseling, education, support services, and public education. ⋯ Constraints, such as funding patterns and the political climate, will be considered as part of the challenge for the next decade. A frame of reference is suggested for meeting the challenges ahead for further humanistic progress.