HLH Case Studies

Responsible for all aspects of the credentialing, re -credentialing and contracting for all medical providers and dental providers who give patient care at the HHD Clinics. Responsible for ensuring medical providers, dental providers, clinics, and programs have been enrolled with health plans and linked to all clinics. Keep data for each provider, clinic, and program to ensure prompt renewal of licenses and certifications. Start the contract process for HHD and potential payers by acting as liaison for HHD and medical payers to ensure contracts are generated for the City of Houston Legal team to review. Also, ensure all services that are given by HHD claims are filed in a prompt matter, follow up and identify any trends for payment to be

CASE STUDY PROGRESS: The client has now received 3 cycles of combination chemotherapy for her breast cancer. Her last treatment with doxorubicin, cyclophosphamide, and 5-fluorouracil was approximately 12 days ago. She came to the emergency room with a 2-day history of fever, chills, and shortness of breath. On arrival, she is disoriented and agitated. Vital signs are 86/43, 119, 28, 39.8° C, SaO2 85% on room air. Laboratory data include WBC 1.2 thou/cmm, Hct 24.9%, Hgb 8.7 g/dl, platelets 125 thou/cmm. Differential WBC count shows 37% granulocytes, 60% lymphocytes, 3% monocytes. Chem 14 is within normal limits, with the exception of BUN 28 mg/dl, creatinine 1.6 mg/dl, and lactic acid 2.4 mg/dl. Chest x-ray demonstrates diffuse infiltrates in the left lower lung.

Juvenile lupus is a “disease in which the immune system is overactive and does not function properly” (College of Rheumatology). As with many autoimmune conditions, the immune system attacks healthy tissues. In the case of juvenile lupus the immune system attacks different organs in the body, which results in painful inflammation in the child (College of Rheumatology). There are multiple possible factors included in the cause of juvenile lupus, like hormones and the environment, but because the cause of lupus is still unknown, no one really knows how to prevent it from happening in children (College of Rheumatology). There is no cure for lupus, but there are many successful treatments to help children and teens with juvenile lupus (College of Rheumatology).

Scenario: John is a 4 year-old boy who was admitted for chemotherapy following diagnosis of acute lymphoblastic leukemia (ALL).  He had a white blood cell count of 250,000.  Clinical presentation included loss of appetite, easily bruised, gum bleeding, and fatigue.  Physical examination revealed marked splenomegaly, pale skin color, temperature of 102°F, and upper abdomen tenderness along with nonspecific arthralgia.

Systemic lupus erythematosus (SLE) also referred to lupus dates back to the middle ages and has made an explosion in the past 60 years. Even though more than 1.5 million Americans have lupus and 90% of lupus sufferers are women, between the ages of 15 to 44 (Lupus Research Institute), there is little awareness about the disease. 72% of Americans aged 18-34 have either not heard of the disease or know nothing about it (Medical News Today). However, researchers continue on working to have a better understanding of SLE factors, pathophysiology, current treatment and new prospects for treatment.

DK is a 51-year old male patient presenting with Acute Myeloid Leukemia AML. Two weeks ago while vacationing in Ocean City with his family, DK visited the local hospital with the symptoms of swollen leg, difficulty walking, pain, and fever. Bloodwork was performed at the local clinic and revealed anemia and low cell counts indicating possible leukemia. Patient returned to Baltimore and was admitted to Johns Hopkins Hospital 1 week ago. His current symptoms are swelling of lower legs, fever, low blood Oxygen level, anemia.

Systemic lupus erythematosus (SLE) is a multi-organ autoimmune disorder that can cause significant morbidity and mortality. A large body of evidence has shown that African Americans experience the disease more severely than other racial-ethnic groups. We performed a systematic review in the PubMed and Medline Databases of articles published between January(?) 2000 – December 2014 to evaluate research focused on SLE in African Americans. Articles were classified according to their level of evidence. Our literature review reported a wide range of adverse outcomes in

Client A had her four month old baby removed from her care despite our best efforts at a 1027 hearing. It was alleged the baby had fractured ribs, and it was either the father or mother so charges were filed against both parents. The trial stretched out over several months and after cross examining the doctor who testified and putting the primary physician on the stand, the Court came back with a finding that our client did not abuse her daughter. Her daughter was immediately returned to her care. Client B is an immigrant who has been a client of HLAS for many years. At one stage, client B had all of her children removed from her care. She worked very hard to get all of her children back, and her two youngest were the last. The father of

Makover, M. & Zieve, D. (2011, February 14). Systemic Lupus Erythematosus. National Center for Biotechnology Information. Retrieved July

Hyperleukocytosis is considered a pediatric oncologic emergency when the WBC is more than 100,000/mm3, which then can cause capillary obstruction, microinfarction and organ dysfunction. Two things that they often experience are respiratory distress and cyanosis. A variety of neurologic changes may take place such as change in loc, problems, agitation, confusion, ataxia, and delirium. Care for hyperleukocytosis would consist of rapid cytoreduction done through chemotherapy, hydration, alkalinization of the urine and medication(allopurinol). Depending on the circumstance it may be necessary to use leukophoresis

Lupus nephritis causes inflammation of the nephrons, which is caused by systemic lupus erythematosus (SLE or lupus). The kidney’s main function is to remove waste from blood and to balance the amount of fluids in your body. When inflammation of nephrons occur it makes it harder to filter the blood and can cause significant swelling. It is an autoimmune disease that causes the immune system to mistake harmful substances from healthy ones which results in the immune system attacking the healthy tissues and cells. It is still unknown on how the disease comes about except for these two assumptions; genetic predisposition and research found on Renal DNase1 enzyme activity. Genetic predisposition refers to environmental factors

Because Hodgkin’s disease is associated with a defect in the maturation of the lymphocyte, the immune system may be impaired. As such repeated infections may occur.

Choice “E” is the best answer. X-linked lymphoproliferative (XLP) syndrome is an immunodeficiency syndrome characterized by the following: a predilection for hemophagocytic lymphohistiocytosis, fatal or near-fatal Epstein-Barr virus–induced infectious mononucleosis in childhood, subsequent hypogammaglobulinemia, and a markedly increased risk of lymphoma or other lymphoproliferative diseases.

described in Materials and methods. (B) Two unique restriction sites (AsiS I and Swa I)

a diagnosis of exclusion. IIH is typically found in women of childbearing age who are