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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty-six febrile neutropenic episodes were treated by granulocyte transfusions in 33 children. Septicemia and mucous membrane ulcerations were most commonly associated with the fever. Infection cleared in 81% of the episodes, eight per cent ended in death from bacterial infections, 11% from nonbacterial infections or hemorrhage. The median number of polymorphonuclear leukocytes given was 1.1 X 10(10)/m2/transfusion. Two to twenty-eight (median 8.5) transfusions were given over 3--34 days (median 10.5). The source of cells (parental or random) and the method of collection did not seem to affect the outcome. None of the 23 patients whose marrow recovered during the transfusions died of bacterial infections. Infection cleared even without marrow recovery in 62% of the patients, but then only 25% lived for more than two months after clearing of sepsis. In a subgroup of patients with nonlymphoblastic leukemia on the same chemotherapy and antibiotic treatment protocol, 8/11 (73%) survived bacteremia when white cell support was available; only 2/11 (18%) of a historical control group survived when such support was not available. Granulocyte support appears to be a valuable tool in helping neutropenic patients overcome their infections or, at the very least, helping them survive long enough for normal marrow recovery to occur.
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PMID:Granulocyte transfusions in infected neutropenic children with malignancies. 44 Feb 6

During 23 exchange transfusions, the granulocytes from 27 donors and 16 newborn infants were tested for opsonic activity and granulocyte function by the nitrobluetetrazolium test. Granulocyte function in a newborn baby receiving an exchange transfusion can be altered positively or negatively, depending on the quality of the donor's blood. If exchange transfusion is used in the management of neonatal sepsis, special attention should be given to the immunological properties of the donor blood.
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PMID:Exchange transfusion in newborn infants: effects on granulocyte function. 51 6

Granulocytes for transfusion can now be obtained from normal donors by one of four techniques that involve either centrifugation or reversible adhesion of granulocytes to nylon fibers. The leukapheresis process appears to be safe for donors and standards for the selection and care of donors are being formulated. It appears desirable to transfuse granulocytes that are compatible in a leukoagglutination crossmatching, however, better methods for histocompatibility testing must be developed. Granulocyte transfusions clearly are of benefit to patients with Gram-negative sepsis and granulocyte counts of less than 500/cu mm for at least ten days. They may be valuable for granulocytopenic patients with other severe infections; however, there is no indication that granulocyte transfusions are indicated prophylactically or for febrile granulocytopenic patients without evidence of infection.
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PMID:Leukapheresis and granulocyte transfusion. 57 63

A modified bone marrow clonal cell culture technique was used to study granulocyte production during burn injury and sepsis. When rats were inflicted with a 30 percent third-degree scald burn, marrow cellularity and colony-forming units in culture (CFU-C) per 10(5) marrow cells increased progressively to four times normal by 7 days after injury. Conversely, When animals were burned and the burn wound immediately seeded with 10(8) Pseudomonas organisms, CFU-C declined steadily until the day of death and reflected a progressive loss in marrow cellularity. Further studies were conducted replacing or mixing standard colony-stimulating serum with burn, burn-infected, or normal rat serum. The results indicated that colony-stimulating activity could be supplied by postburn serum, but not with normal or burn-infected rat serum. Additionally, serum from burned-infected animals significantly inhibited colony formation when added to the standard colony-stimulating serum. Marrow failure appears to be the major cause for granulocytopenia in burn infection and may partly be serum mediated.
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PMID:Myelopoiesis in the infected burn. 83 11

The function of blood neutrophil granulocytes was studied in vitro in 17 patients with preleukaemia. 3 patients had a cellular defect of chemotaxis. 2 of them had monosomy-7 in bone marrow karyotype, in 1 associated with the deletion of the long arm of a chromosome 20. The third patient had trisomy-8. In the patient with trisomy-8, the high percentage of band neutrophils was possibly associated with the chemotactic defect. In another patient with trisomy-8 chemotaxis was normal. There was a statisically significant tendency to reduced phagocytosis and impaired ability to kill Staphylococcus aureus. 1 patient with a chemotactic defect and monosomy-7 suffered from repeated infections. The other 2 patients with defective chemotaxis had several febrile episodes most probably of infectious origin, and 1 of them died in sepsis. All of these 3 patients had cutaneous abscesses. It is concluded that defects in neutrophil granulocyte function are not uncommon in preleukaemia and may result in reduced resistance to infection.
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PMID:Function of neutrophils in preleukaemia. 85 6

Neutrophil granulocyte function was determined in three patients with systemic staphylococcal infection, clinical manifestations of generalized allergic disease, and hyperimmunoglobulinemia E. Each of the patients had urticarial skin rashes before or at the time of development of staphylococcal suppurative lymphadenitis, pneumonia, or sepsis. Neutrophil chemotaxis, random migration, phagocytosis, and bactericidal capacity were assessed to determine if an abnormality in these functions might have contributed to the development of severe staphylococcal infections. Each of the three patients with generalized urticaria was found to have a marked defect in neutrophil chemotaxis. The mean chemotactic index of the patients was 12 +/- 4, whereas that of 20 controls was 72 +/- 11. Neutrophil random migration, phagocytosis, and bactericidal capacity were normal in each patient. The serum or plasma of the patients did not inhibit chemotaxis of control neutrophils and did not contain an increased concentration of the chemotactic-factor inactivator found in normal serum. Treatment of the neutrophils of these three patients with the competitive histamine H2 receptor blocking agent, burimamide, produced a significant increase in chemotactic responsiveness. These studies suggest the possibility of pharmacologic modification of neutrophil granulocyte function.
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PMID:Severe staphylococcal disease associated with allergic manifestations, hyperimmunoglobulinemia E, and defective neutrophil chemotaxis. 97 42

The purpose of this study was to determine the value of prophylactic granulocyte transfusions in preventing death from sepsis. An intravenous dose of 10(9) Escherichia coli was lethal when given to granulocytopenic rats 6 days following irradiation with 750 rads. Only one of 22 irradiated animals survived the septicemia. Although normal (nonirradiated) animals experienced a transient leukopenia from this dose of organisms, it was less than LD10 for the normal host. There were no deaths in a group of animals receiving irradiation only. A group of 14 irradiated animals was given a single granulocyte transfusion 2 hr before the septic inoculum, and 57% of these animals survived (p less than 0.01). No antibiotic therapy was administered to any of these animals. Irradiated animals who received granulocytes and recovered from sepsis had earlier granulocyte reconstitution than animals irradiated but not given the septic challenge. Platelet reconstitution was the same in both groups. In the rat model, prophylactic granulocyte support of septc animals led to improved survival. It was concluded that granulocyte prophylaxis may be of value in selected patients with transient bone marrow failure who are therefore at high risk from sepsis.
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PMID:Prophylactic granulocyte support in experimental septicemia. 125 16

An experimental model was designed to evaluate a combined protocol of active immunization and granulocyte transfusions for treatment of Pseudomonas aeruginosa sepsis in the neutropenic host. One member of a pair of dogs was immunized with P. aeruginosa vaccine. Both dogs were then rendered transiently neutropenic with a single intravenous dose of cyclophosphamide (40 mg. per kilogram) and challenged with an intravenous inoculum of P. aeruginosa. Twenty-four and 48 hours after pseudomonas challenge each animal received granulocyte transfusions. Effectiveness of therapy was evaluated by observation of survival time, febrile response, and quantitative blood cultures. Results showed a significant increase in the survival period (P is less than 0.05), a lower febrile response (P is less than 0.025), negative blood cultures, and a greater recovery rate in the immune group. Immune dogs that died had negative blood cultures or less than or equal to 10 pseudomonas per milliliter of blood despite the presence of P. aeruginosa in tissues. In contrast, control dogs had septic deaths within 67 hours of pseudomonas challenge, marked febrile responses with 24 hours of infection, and positive blood cultures with 4,000 to 25,800 pseudomonas per milliliter of blood. These data show that combined therapy with immunization and granulocyte transfusions is effective in reducing the severity of P. aeruginosa infection and in preventing bacteremia during periods of leukopenia.
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PMID:Combined pre-immunization and granulocyte transfusion therapy for treatment of pseudomonas septicemia in neutropenic dogs. 127 Aug 91

Report of a T-cell rich B-cell lymphoma (TCRBCL) in a 43 years old man with an associated haemophagocytic syndrome (HS). At presentation the haemophagocytic cells involved the same organs as the lymphoma, i.e. spleen, liver, abdominal lymph nodes and bone marrow. As supportive measure to alleviate chemotherapy-induced granulocytopenia the cytokine granulocyte-macrophage colony-stimulating factor (GM-CSF) was given. After an initial improvement of the blood granulocyte count pancytopenia developed again, resulting in fatal sepsis. Autopsy demonstrated massive proliferation of macrophages in the bone marrow with haemophagocytosis as morphological correlation to the pancytopenia. The observation that exogenous GM-CSF enhanced the preexistent HS primarily reactive to the TCRBCL raises the question if endogenous GM-CSF may play a role in triggering a HS. The observed association of TCRBCL and HS has not been reported so far.
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PMID:[T-cell rich B-cell lymphoma associated with hemophagocytic syndrome]. 128 41

Eighteen cases of alloimmune neonatal neutropenia (ANN) were analysed for their clinical and serological properties. Pregnancy was normal in all cases, but a 50% incidence of abortion is recorded. With the exception of two premature babies, all newborns were delivered at term. Omphalitis and mild infections of the skin were predominantly present. None of the new-borns died by overwhelming sepsis. The average duration of neutropenia was 11 weeks (range 3-28 weeks). Intravenous IgG therapy was followed by transient remission in 2 of 4 affected newborns. Antibody differentiation revealed in five sera NA1-, in four sera NA2- and in two sera NB1-specific antibodies. In two sera only HLA antibodies were detectable. Complement activating antibodies were determined in 72% of the sera. Screening for granulocyte-specific antibodies in 1016 postpartum sera of unselected women revealed a total of 11 sera (1.1%) reacting selectively with granulocytes, but only four (0.4%) were directed against a known granulocyte-specific antigen. None of the new-born of mothers alloimmunized to granulocyte antigens developed neutropenia, which suggests an incidence of ANN below 0.1%.
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PMID:Serological and clinical aspects of granulocyte antibodies leading to alloimmune neonatal neutropenia. 128 78


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