@article {8492, title = {"Safety and utility of percutaneous liver biopsy in hematopoietic stem cell transplant pediatric recipients: a retrospective study".}, journal = {BMC Cancer}, volume = {16}, year = {2016}, month = {2016}, pages = {590}, abstract = {

BACKGROUND: Liver biopsies in pediatric hematopoietic stem cell transplantation (HSCT) patients are as and effective when performed at bedside in the Bone Marrow Transplant Unit (BMTU) than in the Day Surgery Unit (DSU), with better patient compliance and lower emotional distress for these children.

METHODS: The study group consisted of 45 children who underwent allogeneic HSCT. We reviewed 68 liver biopsies performed between April 2006 and September 2015. 12 (17.6~\%) biopsies were performed in the DSU and 56 (82.3~\%) in the BMTU; nine (13.2~\%) prior to HSCT and 59 (86.7~\%) after HSCT. Pre-procedural behavioral status (subjective score) was evaluated by pediatric transplant physicians by filling in a questionnaire employing a three-point scale: "calm and cooperative", "agitated and non-cooperative" or "frightened and suffering". Objective score was obtained measuring patient{\textquoteright}s heart rate before the procedure and comparing it with mean heart rate.

RESULTS: Patients who underwent the procedure at the BMTU experienced less emotional distress than those who underwent it in the DSU: 58.3~\% of patients treated at the DSU were agitated as compared with 16.1~\% of those treated at the BMTU (p < 0.01). Among the 59 biopsies performed after HSCT, 41 (69.5~\%) were taken from symptomatic patients for a diagnostic purpose and 18 (30.5~\%) in asymptomatic ones in order to rule out hepatic GVHD. Among these 18 procedures, GVHD was diagnosed in 16 (88.9~\%) cases. Minor complications occurred in about 17~\% of procedures (12 biopsies), at a rate of 25~\% for the DSU location compared with 16~\% for the BMTU location. Only two major complications were reported, one in the DSU and one in the BMTU.

CONCLUSION: Liver biopsy performed at bedside in HSCT patients does not carry a higher risk of adverse events than the same procedure performed in the DSU and has lower emotional distress associated with better patient compliance, thus contributing significantly to a higher standard of care.

}, issn = {1471-2407}, doi = {10.1186/s12885-016-2603-8}, author = {Maximova, Natalia and Gregori, Massimo and Barbieri, Francesca and Pizzol, Antonio and Sonzogni, Aurelio} } @article {8490, title = {Torticollis as the Presenting Sign of Cervical Spondylodiscitis.}, journal = {Pediatr Emerg Care}, year = {2016}, month = {2016 Feb 10}, abstract = {

Acquired torticollis is a common clinical finding in children evaluated in the pediatric emergency department. It may be the presentation symptom of different illnesses, such as trauma, muscle contraction, infections, or malignancies, and an accurate differential diagnosis is required to correctly identify the cause and choose the right treatment. Spondylodiscitis is a low-grade bacterial infection that involves intervertebral disks and the adjacent vertebral bodies. Spondylodiscitis of the cervical spine is unusual and may be a rare cause of torticollis. We report the case of a 4-year-old male patient admitted to the emergency department for a 5-day history of painful torticollis. Blood tests showed an elevated erythrocyte sedimentation rate. The radiograph of the cervical spine showed a thin fifth cervical soma. The magnetic resonance imaging of cervical spine showed the alteration of cervical vertebral bodies and intervertebral disks, suggesting the diagnosis of cervical spondylodiscitis. The patient recovered after endovenous antibiotic treatment. We suggest that cervical spondylodiscitis should be suspected and investigated by means of an magnetic resonance imaging in every case of unexplained torticollis with persisting symptoms.

}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000000643}, author = {Pizzol, Antonio and Bramuzzo, Matteo and Pillon, Roberto and Taddio, Andrea and Barbi, Egidio} } @article {7705, title = {Does defibrotide induce a delay to polymorphonuclear neutrophil engraftment after hematopoietic stem cell transplantation? Observation in a pediatric population.}, journal = {Adv Ther}, volume = {32}, year = {2015}, month = {2015 Apr}, pages = {381-6}, abstract = {

INTRODUCTION: In recent years, defibrotide (DFT) has emerged as a promising therapy for veno-occlusive disease (VOD). The aim of this study was to investigate whether DFT prophylaxis affects neutrophil engraftment in patients undergoing hematopoietic stem cell transplantation (HSCT).

METHODS: A cohort of 44 consecutive pediatric patients who underwent HSCT was retrospectively analyzed to see the role of DFT on engraftment. Patients were assigned into two groups based on the use or non-use of prophylaxis with DFT.

RESULTS: The mean time to engraftment was statistically different between the two groups for both polymorphonuclear neutrophils (PMN) and white blood cells.

CONCLUSION: Our study supports the hypothesis that prophylaxis with DFT for VOD leads to a delay to the engraftment of PMN in pediatric patients that underwent HSCT.

}, issn = {1865-8652}, doi = {10.1007/s12325-015-0203-7}, author = {Maximova, Natalia and Pizzol, Antonio and Giurici, Nagua and Granzotto, Marilena} } @article {3599, title = {Does Teno Torque Virus Induce Autoimmunity After Hematopoietic Stem Cell Transplantation? A Case Report.}, journal = {J Pediatr Hematol Oncol}, volume = {37}, year = {2015}, month = {2015 Apr}, pages = {e194-7}, abstract = {

Teno Torque virus, member of the family of Anelloviridae, has been associated with many autoimmune diseases such as idiopathic hepatitis, systemic lupus erythematosus, and multiple sclerosis. Its viral load tends to be higher in the bone marrow and in tissues with high turnover rate. We report here a case of an 11-month-old infant affected by acute myeloid leukemia who underwent hematopoietic stem cell transplantation, and after 6 months had autoimmune hepatitis and atopic dermatitis. Extremely high-cytokine IP-10 and eotaxin levels were found in her sera, and serological tests and RT-PCR for viruses showed positive results exclusively for Teno Torque virus.

}, keywords = {Autoimmune Diseases, Autoimmunity, Dermatitis, Atopic, DNA Virus Infections, DNA, Viral, Female, Hematopoietic Stem Cell Transplantation, Hepatitis, Humans, Infant, Leukemia, Myeloid, Acute, Prognosis, Torque teno virus, Viral Load}, issn = {1536-3678}, doi = {10.1097/MPH.0000000000000194}, author = {Maximova, Natalia and Pizzol, Antonio and Ferrara, Giovanna and Maestro, Alessandra and Tamaro, Paolo} } @article {7704, title = {Polyclonal gammopathy after BKV infection in HSCT recipient: a novel trigger for plasma cells replication?}, journal = {Virol J}, volume = {12}, year = {2015}, month = {2015}, pages = {23}, abstract = {

BACKGROUND: BK polyomavirus infects most of the general population. However, its clinical manifestations are almost exclusively seen in immunocompromised patients, particularly in kidney and hematopoietic stem cell transplantation recipients.

CASE PRESENTATION: A 15-y-old female suffering from common B-cell acute lymphoblastic leukaemia underwent hematopoietic stem cell transplantation. The patient had reactivation of BKPyV infection and developed an haemorrhagic cystitis. Three months after transplant, BKPyV viremia and viruria increased and she developed a severe nephropathy associated to a polyclonal gammopathy with high levels of isolated IgM.

CONCLUSION: This case report describes a rare and unexpected polyclonal gammopathy developed during a polyomavirus-associated nephropathy confirmed by immunohistochemical and laboratory analyses.

}, issn = {1743-422X}, doi = {10.1186/s12985-015-0254-z}, author = {Maximova, Natalia and Pizzol, Antonio and Sonzogni, Aurelio and Gregori, Massimo and Granzotto, Marilena and Tamaro, Paolo} }