Hyperglycemia as a possible risk factor for mold infections—the potential preventative role of intensified glucose control in allogeneic hematopoietic stem cell transplantation

Fuji, Shigeo; Löffler, Jürgen; Savani, Bipin N.; Einsele, Hermann; Kapp, Markus

doi:10.1038/bmt.2016.306

Cited by 21 publications

(17 citation statements)

References 63 publications

(74 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…17,18 Multiple case series have identified diabetes mellitus as a risk factor for invasive mold infections, but prospective data for improving glucose control in this population are limited. 19 In conclusion, mucormycosis should be considered in patients…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, the importance of hyperglycemia should not be underestimated and can be particularly challenging with high‐dose glucocorticoids and calcineurin inhibitors . Multiple case series have identified diabetes mellitus as a risk factor for invasive mold infections, but prospective data for improving glucose control in this population are limited …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Margoles

DeNofrio

Patel

et al. 2018

Transplant Infectious Dis

View full text Add to dashboard Cite

Mucorales organisms are an uncommon cause of invasive fungal infections after solid organ transplantation but are associated with great morbidity and mortality. We report a fatal case of disseminated Cunninghamella infection early after heart transplantation. The patient developed graft dysfunction and elevated markers of myocyte injury and autopsy revealed fulminant fungal myocarditis. This case highlights the need for a high index of suspicion in immunocompromised patients who are not improving with standard antimicrobial therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Margoles

DeNofrio

Patel

et al. 2018

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…Although the underlying pathophysiology of the association between hyperglycemia and adverse outcomes is more clearly hypothesized to be related to known immunologic effects such as increased inflammation and impaired leukocyte function, the possible pathophysiologic relationship between glycemic variability and outcomes is less well described 1,15,20‐23 . However, several studies have demonstrated associations between wide glucose fluctuations and both oxidative stress and endothelial cell apoptosis, which may lead to microvascular damage, inflammatory milieu, and disruption of normal immune function 24‐26 .…”

Section: Discussionmentioning

confidence: 99%

Glycemic variability is associated with poor outcomes in pediatric hematopoietic stem cell transplant patients

Sopfe

Campbell

Keating

et al. 2020

Pediatric Blood & Cancer

View full text Add to dashboard Cite

Background: Among pediatric hematopoietic stem cell transplant (HSCT) recipients, abnormal glycemic control is shown to be associated with increased risk of transplantrelated mortality, death from any cause, risk of infection, increased hospitalized, and intensive care days. Independent effects of higher glycemic variability, a component of glycemic control, have not been described. This study aimed to characterize risk factors for, and consequences of, higher glycemic variability in HSCT patients. Procedure: Medical records for a cohort of 344 patients, age 0-30 years, who underwent first HSCT from 2007 to 2016 at Children's Hospital Colorado were retrospectively reviewed. Glucose coefficients of variation (CV) were analyzed for HSCT days −14 to 0 and 0-30, and patients were assessed for potential risk factors and outcomes. Results: Roughly one-third of patients had pre-HSCT and day 0-30 glucose CV above the reported healthy adult range. Independent of HSCT type, doubling of pre-HSCT glucose CV was associated with a 4.91-fold (95% confidence interval [CI], 1.40-17.24) increased hazard of infection, as well as increased risk for intensive care hospitalization for allogenic HSCT patients. Multivariable analysis demonstrated that allogeneic HSCT patients had a 1.40-and 1.38-fold (95% CI, 0.98-1.99 and 1.00-1.91) increased hazard of death for every doubling of pre-HSCT and day 0-30 glucose CV, respectively. Conclusions: Just as with higher mean glucose, higher glycemic variability in the pediatric HSCT population is independently associated with significantly increased morbidity. Additional research is required to evaluate the utility of glucose control to mitigate these relationships and improve HSCT outcomes.

show abstract

“…DM as a complication of major thalassemia is usually manifested after the first decade of life [82,83]. Hyperglycemia in hematological patients may also be the result of infections or certain medications [84][85][86]. For instance, corticosteroids are frequently used for the treatment of both malignant and benign (e.g., immune thrombocytopenia and autoimmune hemolytic anemia) disorders.…”

Section: Hyponatremia Due To Disorders Of Endocrine System and Metabomentioning

confidence: 99%

Hyponatremia in Patients with Hematologic Diseases

Koumpis

Florentin

Hatzimichael

et al. 2020

JCM

View full text Add to dashboard Cite

Hyponatremia is the most common electrolyte disorder in clinical practice and is associated with increased morbidity and mortality. It is frequently encountered in hematologic patients with either benign or malignant diseases. Several underlying mechanisms, such as hypovolemia, infections, toxins, renal, endocrine, cardiac, and liver disorders, as well as the use of certain drugs appear to be involved in the development or the persistence of hyponatremia. This review describes the pathophysiology of hyponatremia and discusses thoroughly the contributing factors and mechanisms that may be encountered specifically in patients with hematologic disorders. The involvement of the syndrome of inappropriate antidiuretic hormone (SIADH) secretion and renal salt wasting syndrome (RSWS) in the development of hyponatremia in such patients, as well as their differential diagnosis and management, are also presented. Furthermore, the distinction between true hyponatremia and pseudohyponatremia is explained. Finally, a practical algorithm for the evaluation of hyponatremia in hematologic patients, as well as the principles of hyponatremia management, are included in this review.

show abstract

Hyperglycemia as a possible risk factor for mold infections—the potential preventative role of intensified glucose control in allogeneic hematopoietic stem cell transplantation

Cited by 21 publications

References 63 publications

Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Disseminated mucormycosis masquerading as rejection early after orthotopic heart transplantation

Glycemic variability is associated with poor outcomes in pediatric hematopoietic stem cell transplant patients

Hyponatremia in Patients with Hematologic Diseases

Contact Info

Product

Resources

About