Drug-induced hemolytic anemia is an immune-mediated phenomenon that leads to the destruction of red blood cells. Here, we present a case of lifethreatening ceftriaxone-induced hemolytic anemia (CIHA) in a previously healthy 3-year-old girl. We also reviewed the literature to summarize the clinical features and treatment of hemolytic anemia. Acute hemolysis is a rare side effect of ceftriaxone therapy associated with high mortality. Our patient had a sudden loss of consciousness with macroscopic hematuria and her hemoglobin dropped from 10.2 to 2.2 g/dl over 4 hours, indicating that the patient had life-threatening hemolysis after an intravascular dose of ceftriaxone who had previously been treated with ceftriaxone in intramuscular form for six days. CIHA is associated with a positive direct antiglobulin test, revealing the presence of IgG in all cases and C3d in most cases. Our patient's direct antiglobulin test was positive for IgG (3+) and for C3d (4+). The case was managed successfully with supportive measures and intravenous immunoglobulin therapy. Ceftriaxone is used very frequently in children; an early diagnosis and proper treatment of hemolytic anemia are essential to improve the patient outcome. The pathophysiological mechanism is the same as for non-drug autoimmune hemolytic anemia. However, there is still no consensus treatment for CIHA. Intravenous immunoglobulin can be used in clinical emergencies, such as our case, or in refractory cases.

were excluded. Demographic, clinical and surgico-pathological data were analysed. Results: 69 patients underwent excision of SCLN, of which 4 were upfront and 65 were delayed, after mean 4.5 (range 2-10) cycles of neoadjuvant chemotherapy. All 4 upfront excisions yielded mean 2.8 (range 1-5) metastatic lymph nodes. 59 (90.8%) patients with delayed excisions yielded mean 4.5 (range 1-20) metastatic lymph nodes, while 6(9.2%) patients yielded no tumor infiltration in mean 8 (range 3-27) lymph nodes. Initial diagnostic tests that detected SCLN metastases included PET-CT(n=50), MIBG(n=5), CT(n=17) and biopsy(n=9). 8 of 65 Stage 4 patients had SCLN-only metastases. Left-sided SCLN

The possible involvement of voltage sensitive calcium channels (VSCCs) in both locomotor activity and striatal homovanillic acid (HVA) alterations in acutely low (0.5 g/kg) and high (2 g/kg) dose ethanol-treated rats was investigated. Both doses of ethanol produced inhibitory effects on both locomotor activity and striatal HVA levels. Bay K 8644 significantly potentiated and nifedipine reversed the locomotor inhibitory effect of low-dose ethanol, whereas both drugs did not alter locomotor activity and striatal HVA levels, when used alone. On the other hand, both Bay K 8644 and nifedipine significantly reversed the decrease in striatal HVA levels induced by the low and high doses of ethanol.

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Background. Granulocytic sarcoma (GS) is an extramedullary solid tumor composed of immature myeloid cells. GS has been associated with acute myeloid leukemia (AML), myelodysplastic syndromes or myeloproliferative diseases. Although GS can affect various tissues of the human body, it has rarely been reported in other soft tissues such as the breast, gastrointestinal, respiratory and genitourinary tracts. We report a pediatric case diagnosed with granulocytic sarcoma of the bladder and concomitant AML.Case. A twelve-year-old previously healthy girl was admitted to the pediatric urology clinic with a ten-day history of hematuria and pollakiuria. Laboratory examinations revealed anemia, thrombocytopenia and neutrophilic leukocytosis. Bone marrow aspiration results were consistent with acute myeloid leukemia -FAB subtype M2-. Abdominal magnetic resonance imaging (MRI) showed an irregularly bounded 12 cm mass on the right side of the bladder. Transurethral resection (TUR) pathology was consistent with granulocytic sarcoma. After a multimodal treatment approach, complete remission was achieved. Conclusions.Malignant bladder masses are rare causes of macroscopic hematuria in childhood. The diagnostic spectrum is wide, ranging from rhabdomyosarcoma to leukemia involvement. The bladder is a rare site of extramedullary involvement in pediatric patients with AML. Multimodal treatment should be considered on a per-patient basis.