ICL Case Study

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.

Known or suspected human acquired immunodeficiency virus (HIV) - positive patients, or severe diseases such as acquired immunodeficiency syndrome (AIDS) or tuberculosis.

K.D. is a 36-year-old gay professional man who has been human immunodeficiency virus (HIV) positive for 6 years. Until recently, he demonstrated no signs and symptoms (S/S) of acquired immunodeficiency syndrome (AIDS). The appearance of purplish spots on his neck and arms persuaded him to make an appointment with his physician. When he arrives at the physician’s office, the nurse performs a brief assessment. His vital signs (VS) are 138/86, 100, 30, 100.8° F. K.D. states that he has been feeling fatigued for several months and is experiencing occasional night sweats, but he also has been working long hours, has skipped meals, and has been particularly stressed over a project at work. K.D.’s physical examination is within normal limits (WNL) except for his rapid heart rate and respirations, low-grade fever, and skin lesions. The doctor orders a chest x-ray (CXR), CBC, lymphocyte studies, ultra viral load, Cytomegalovirus (CMV) assay, and a PPD (purified protein derivative) test. K.D. made an appointment

Leukemia broadly describes conditions that affect erythropoiesis in the bone marrow, lymphatic system, and spleen. As with all other cancers, leukemia begins from the mutation of DNA in certain cells. Classifications of leukemias are based on the age of onset and the leukocyte involved (Lewis et al. 2014, 665). The most common leukemia is chronic lymphocytic leukemia (CLL), accounting for approximately 30% of cases in the United States (Copstead and Banasik 2013, 222). The normal function of the bone marrow, spleen, and liver becomes interrupted by the invasion of malignant lymphocytes (B cells); since the B cells are functionally inactive, a patient becomes more susceptible to infections. The sluggish progression of CLL unfortunately leads to late diagnoses and poor prognosis (Lewis et al. 2014, 665). Patients that become symptomatic in later stages will experience fatigue, weight loss, anorexia, and an increased susceptibility to infection, due to abnormal antibody production. Patient specific factors such as age, disease progression, and medication side effects will determine the course of treatment (Copstead and Banasik 2013, 223). The fragile state of patients with CLL requires continuous examination of drug therapy and interventions to prevent further complications.

Although the aforementioned symptoms are suggestive of IM, a subset of infected patients may be asymptomatic (e.g., subclinical IM) or their symptoms may be attributable to other illnesses such as acute HIV, cytomegalovirus or Lambert-Eaton myasthenic syndrome.1 In order to differentiate IM from other illnesses, diagnostic tests such as the mono-spot assay or EBV-specific antibodies should be

(HIV or AIDS), Lupus and other connective tissue or autoimmune diseases, Leukaemia and other cancers, People taking immune-suppressing drugs, such as cortisone-related medications, tumour necrosis factor, inhibitors, and chemotherapy, People who have had transplants, Pregnancy

This disorder has countless characterizes which includes recurrent infections, bacterial, virus and respiratory tract (Infections and Immunity, 2009). There is no set age for this disorder, CVID, can appear during anytime of life and at any age. The treatment plan for CVID, is immunoglobulin replacement therapy, this must be given regularly for a longer life-spam. Patients with CVID may use antibiotics as a form of treatment, but it will take longer to recover. Steroids ad immunosuppressive drugs are also another way to treat

Patients with primary immunodeficiency (PID) are at an increased risk of malignancy compared with the normal population [1-4]. After infections, malignancy is the second most common cause of death in these patients [1]. According to the Immunodeficiency Cancer Registry (ICR) database on immunodeficiency-associated cancer at the University of Minnesota, the most common types of malignancies among PID patients are NHL, which account for 48.6 percent of cancers seen in PID patients. (UPTODATE). NHL is frequently caused by infection with the ubiquitous EBV. The infection of B-cells by EBV provokes a marked activation of immunoregulatory T-cells and requires restoration of immune homeostasis during convalescence. This is accomplished with difficulty in an individual with significant immune defects. (PAAM). It is not surprising, therefore, that immunodeficient individuals are at great risk of developing immunoregulatory disturbances and lymphoproliferative diseases when confronted by EBV. Patients,

Immunosuppression – It’s more seen in people who have undergone organ transplants or people infected with HIV (12 cases of MCC/100,000 people/year) [16-19].

Phase I clinical trials of Imatinib began in 1998 with the intention to determine the maximally tolerated dose. Chronic CML patients who did not respond to a current chemotherapy for CML, interferon- (IFN), were used. Though the maximally tolerated dose was not identified, remarkably, 53 of the 54 patients showed hematologic responses even though they were already in the chronic stages of CML (Deininger, Buchdunger and Druker, 2005). With such great results, phase II of Imatinib started in 1999. Imatinib was administered to patients in all stages of CML. Essentially, the results of this study backed up the results from phase I. However, this study showed a progression-free prognosis at 18 months in roughly 90% of patients. With both phase I and phase II, the Food and Drug Administration approved Imatinib for the treatment of CML in advanced stage patients, as well as, patients who had previously failed IFN (Deininger, Buchdunger and Druker, 2005).

In conclusion, the risk of PML was stratified based on the anti-JC virus antibodies status, the previous use of immunosuppressant, and the length of natalizumab treatments. In addition, the patients that

HIV stands for Human Immunodeficiency Virus. It is a virus that affects your immune system, which is used for defense against pathogens in your body. This virus is spread through bodily functions, but not saliva, and it is the cause of AIDS, which stands for, Acquired Immunodeficiency Syndrome. Women with HIV are at a higher risk of intrusive Group B Streptococcus. This studied focused on women with and without HIV in Malawi and South Africa. This study got their women from clinics in Soweto, Johannesburg, South Africa and Blantyre, Malawi. These women were divided into three categories based on their CD4 count and infection of HIV. CD4 is a type of white blood cell made in the spleen, thymus and lymph nodes. CD4 is part of the infection fighting system (lymph) as a T-helper cell that helps fight off infection. The categories were no infection, infection and low CD4 counts and infection and high

Opportunistic infections (OIs) are infections that happen frequently and are more serious in individuals with weakened immune systems, including individuals with HIV. They are called “opportunistic” because they can cause overwhelming illnesses and take advantage of your weakened immune system. Most life-threatening OIs occur when your CD4 count is beneath 200 cells/mm. OIs are less normal now than they were in the beginning of HIV and AIDS since there are better treatments to keep a person’s immune system stronger and also lessen the amount of HIV in a person’s body. However, many people with HIV still develop OIs because they may not aware of their HIV infection, they may not keep their HIV levels sufficiently low for their immune system

Common variable immunodeficiency (CVID) is a humoral disorder that impairs the function of the immune system. It affects approximately 1 in 25,000-50,000 individuals, with prevalence varying among populations. Individuals with CVID are vulnerable to foreign invaders, often resulting in sinopulmonary infections that can lead to further complications. The disease is characterised by low serum antibody levels (Boileau et al., 2011) and recurrent infection.

According to WHO there are 35 million people globally who are affected with HIV and one in seven people are unaware of being infected. Therefore it becomes an increasingly important concern to target and cure this epidemic on a global scale. That is not the end of the story though; immunocompromised individuals are even more susceptible to opportunistic HIV infections. These pathogens, which come in different varieties such as bacteria, viruses, protozoans and fungi slowly, deteriorate the host by mounting an immense attack causing HIV induced malignancies.