Articles related to BLEEDING/BLOOD DISORDERS

The researchers discovered that 11 of the participants had likely somatic variants at known pathogenic UBA1 positions, and all 11 had clinical symptoms consistent with VEXAS (Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic) syndrome. Five people (45 percent) did not meet the criteria for previous rheumatologic and/or hematologic diagnoses associated with VEXAS syndrome, but all 11 had anemia, which was macrocytic in 10 people and had concomitant thrombocytopenia in 10 people. One male patient had a pathogenic variant identified prior to the onset of VEXAS-related signs or symptoms, and two female patients had disease caused by heterozygous variants. A previously unreported UBA1 variant was found in one symptomatic patient, with in vitro data supporting a catalytic defect and pathogenicity. Disease-causing UBA1 variants were found in one of 13,591 unrelated individuals, as well as in one of 4,269 men and one in 26,238 women over the age of 50.

The CBC, ordered hundreds of millions of times a year in the US alone, typically reports 19 different values, some of which are redundant and inconsequential. These authors suggest three distinct CBCs. [Subscription Required]

The risk of symptomatic intracranial hemorrhage was lower among the 832 patients receiving direct oral anticoagulant treatment in this cohort study involving 33,207 patients with ischemic stroke who received intravenous thrombolysis at 64 centers in Europe, Asia, Australia, and New Zealand when compared to controls who received no anticoagulation. This outcome held true across subgroups and various selection methodologies.

A 61-year-old woman taking methotrexate for RA, which has been stable for several years, has new monoclonal protein discovered on routine follow-up. Physical and routine labs are normal. Electrophoresis displays an IgG κ monoclonal protein spike of 0.8 g/dL. What is the proper follow-up?

The first treatment for light-chain amyloidosis was approved by the FDA in 2021. Daratumumab-based regimens produce profound hematologic and organ responses, providing a new therapeutic foundation. Early detection, correct fibril typing, the challenges of the very advanced patient, and the lack of therapies to remove amyloid deposits are all being researched but remain elusive.

The timing of re-initiation of antithrombotic therapy needs to be individualized based on the severity of the bleed, among other factors. This article reviews the issue and offers tools and guidelines for determining if and when to restart antiplatelet and oral anticoagulant therapy.