"Post-remission CH in the setting of NPM1mut clearance is common and may result in immunophenotypic changes in myeloid progenitors. It is important to not misinterpret these cells as AML measurable residual disease (MRD)."
9/ "Maintenance with lenalidomide showed no apparent effect on relapse probability in 88 patients randomly assigned for this part of the study."
Two rising interns interested in🩸Heme-Onc & 📚MedEd
Teaching pearls from @NEJM CPC published 6/6/13
Dx spoilers below! @MedTweetorials
2/n First a PR:
Middle age man w/ PMHx HBV infection p/w chronic fevers and progressive weakness, found to have painful asymmetric mixed motor & sensory distal multiple mononeuropathy and nerve biopsy showing active vasculitis diagnosed with...
3/n DDx for mixed motor & sensory multiple mononeuropathy is broad!
▪️Hereditary
▪️Diabetes
▪️Vasculitis
▪️Infections (leprosy, lyme, syphilis, CMV, HIV)
▪️Neoplastic infiltration: (most commonly lymphomatous)
▪️Sarcoid, amyloid
"Sterile pyuria is the persistent finding of white cells in the urine in the absence of bacteria"
And it is super common!
"13.9% of women and 2.6% of men are affected"
🤯 The DDx is waaaaay broader than I suspected, so let's take it by category
1/ STI
▪️Gonorrhea, Chlamydia, Mycoplasma
▪️HSV-2, Herpes Zoster
▪️HPV
▪️"In one study, among 104 patients with untreated HIV infection, 13% had pyuria"
Other viruses that do *not* typically have pyuria: adenovirus, BK, CMV --> sometimes cause hemorrhagic cystitis