@article {3619, title = {Dysplastic bone marrow changes during maintenance therapy for acute leukemia.}, journal = {J Pediatr Hematol Oncol}, volume = {37}, year = {2015}, month = {2015 Mar}, pages = {156-7}, abstract = {

We describe the case of an 8-year-old girl with common precursor B-cell acute lymphoblastic leukemia who presented with severe pancytopenia during maintenance therapy with methotrexate and 6-mercaptopurine. The bone marrow smear showed moderate hypocellularity and trilinear dysplastic changes consistent with a diagnosis of drug toxicity, with no evidence of lymphoblasts. Flow cytometric immunophenotyping was negative for leukemic cells. Blood cell counts normalized after treatment with folinic acid. Maintenance therapy was gradually restarted and she remained well at follow-up visits. Myelotoxicity from methotrexate and 6-mercaptopurine may represent an unpredictable incident during an otherwise uneventful maintenance therapy, and may occur independently of other organ toxicities.

}, keywords = {6-Mercaptopurine, Antineoplastic Combined Chemotherapy Protocols, Bone Marrow Diseases, Child, Disease Management, Female, Follow-Up Studies, Humans, Methotrexate, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma, Prognosis}, issn = {1536-3678}, doi = {10.1097/MPH.0000000000000295}, author = {Chinello, Matteo and Naviglio, Samuele and Shardlow, Alison and Severino, Alessandro and Ventura, Alessandro and Locasciulli, Anna} } @article {3526, title = {A pneumonia that does not improve.}, journal = {Arch Dis Child Educ Pract Ed}, volume = {100}, year = {2015}, month = {2015 Feb}, pages = {18, 55}, keywords = {Airway Obstruction, Bronchoscopy, Child, Preschool, Foreign Bodies, Humans, Pneumonia, Radiography, Thoracic}, issn = {1743-0593}, doi = {10.1136/archdischild-2014-306343}, author = {Naviglio, Samuele and Chinello, Matteo and Ventura, Alessandro} } @article {8084, title = {Splenic Infarction in Acute Infectious Mononucleosis.}, journal = {J Emerg Med}, year = {2015}, month = {2015 Oct 22}, abstract = {

BACKGROUND: The evaluation of a febrile patient with acute abdominal pain represents a frequent yet possibly challenging situation in the emergency department (ED). Splenic infarction is an uncommon complication of infectious mononucleosis, and may have a wide range of clinical presentations, from dramatic to more subtle. Its pathogenesis is still incompletely understood, yet it may be associated with the occurrence of transient prothrombotic factors.

CASE REPORT: We report the case of a 14-year-old boy who presented with fever, sore throat, left upper quadrant abdominal pain, and splenomegaly, with no history of recent trauma. Laboratory tests revealed a markedly prolonged activated partial thromboplastin time and positive lupus anticoagulant. Abdominal ultrasonography showed several hypoechoic areas in the spleen consistent with multiple infarctions. Magnetic resonance imaging eventually confirmed the diagnosis. He was admitted for observation and supportive treatment, and was discharged in good condition after 7~days. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Spontaneous splenic infarction should be considered in the differential list of patients presenting with left upper quadrant abdominal pain and features of infectious mononucleosis; the diagnosis, however, may not be straightforward, as clinical presentation may also be subtle, and abdominal ultrasonography, which is often used as a first-line imaging modality in pediatric EDs, has low sensitivity in this scenario and may easily miss it. Furthermore, although treatment is mainly supportive, close observation for possible complications is necessary.

}, issn = {0736-4679}, doi = {10.1016/j.jemermed.2015.09.019}, author = {Naviglio, Samuele and Abate, Maria Valentina and Chinello, Matteo and Ventura, Alessandro} } @article {7755, title = {Subcutaneous panniculitis-like T-cell lymphoma presenting with diffuse cutaneous edema in a 2-year-old child.}, journal = {J Pediatr Hematol Oncol}, volume = {37}, year = {2015}, month = {2015 May}, pages = {329-30}, keywords = {Child, Preschool, Edema, Humans, Lymphoma, T-Cell, Male, Panniculitis, Skin Diseases}, issn = {1536-3678}, doi = {10.1097/MPH.0000000000000312}, author = {Chinello, Matteo and Naviglio, Samuele and Remotti, Daniele and Locasciulli, Anna and Ventura, Alessandro} } @article {1713, title = {Exenatide in type 2 diabetes.}, journal = {Lancet}, volume = {376}, year = {2010}, month = {2010 Sep 25}, pages = {1052-3; author reply 1053}, keywords = {Biological Markers, Diabetes Mellitus, Type 2, Energy Intake, Humans, Hypoglycemic Agents, Insulin, Insulin, Long-Acting, Peptides, Quality of Life, Venoms}, issn = {1474-547X}, doi = {10.1016/S0140-6736(10)61485-7}, author = {Verzegnassi, Federico and Chinello, Matteo} }