1. Cerebral toxoplasmosis in a diffuse large B cell lymphoma patientLina Savšek, Tanja Roš-Opaškar, 2016, original scientific article Abstract: Toxoplasmosis is an opportunistic protozoal infection that has, until now, probably been an underestimated cause of encephalitis in patients with hematological malignancies, independent of stem cell or bone marrow transplant. T and B cell depleting regimens are probably an important risk factor for reactivation of a latent toxoplasma infection in these patients. Case report. We describe a 62-year-old HIV-negative right-handed Caucasian female with systemic diffuse large B cell lymphoma who presented with sudden onset of high fever, headache, altered mental status, ataxia and findings of pancytopenia, a few days after receiving her final, 8th cycle of rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone (R-CHOP) chemotherapy regimen. A progression of lymphoma to the central nervous system was suspected. MRI of the head revealed multiple on T2 and fluid attenuated inversion recovery (FLAIR) hyperintense parenchymal lesions with mild surrounding edema, located in both cerebral and cerebellar hemispheres that demonstrated moderate gadolinium enhancement. The polymerase chain reaction on cerebrospinal fluid (CSF PCR) was positive for Toxoplasma gondii. The patient was diagnosed with toxoplasmic encephalitis and successfully treated with sulfadiazine, pyrimethamine and folic acid. Due to the need for maintenance therapy with rituximab for lymphoma remission, the patient now continues with secondary prophylaxis of toxoplasmosis. Conclusions. With this case report, we wish to emphasize the need to consider cerebral toxoplasmosis in patients with hematological malignancies on immunosuppressive therapy when presenting with new neurologic deficits. In such patients, there are numerous differential diagnoses for cerebral toxoplasmosis, and the CNS lymphoma is the most difficult among all to distinguish it from. If left untreated, cerebral toxoplasmosis has a high mortality rate; therefore early recognition and treatment are of essential importance.
Keywords: toxoplasmosis, cerebral, lymphoma, rituximab
Published in DiRROS: 30.04.2024; Views: 79; Downloads: 52
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2. Cisplatin-induced non-convulsive posterior reversible encephalopathy syndrome in a 41-year-old woman with metastatic malignant melanomaJanja Ocvirk, Marko Boc, Martina Reberšek, Tanja Roš-Opaškar, 2009, original scientific article Abstract: Background. Cisplatin, a widely used antineoplastic agent usually induces peripheral neuropathy, but can rarely also complicate with encephalopathy, with or without seizures. Case report. We report a case of a young patient with metastatic malignant melanoma with signs and symptoms of cisplatin-induced non-convulsive posterior reversible encephalopaty syndrome. Within the days shortly after the first cycle of cisplatin based chemotherapy the patient suffered from nausea, vomitus, headache, severe pain at the site of sub-cutaneous metastases and confusion. She later experienced somnolence, cortical blindness and aphasia, but without epileptic seizures. Conclusions. Cisplatin is an effective chemotherapeutic drug but also very toxic one and physicians using it must also be aware of possible encephalopathy.
Published in DiRROS: 08.03.2024; Views: 147; Downloads: 41
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8. Razsejan rak dojkSimona Borštnar, Jožica Červek, Maja Ebert Moltara, Cvetka Grašič-Kuhar, Tanja Marinko, Erika Matos, Marina Mencinger, Tanja Roš-Opaškar, Boštjan Šeruga, Erik Škof, Andreja Cirila Škufca Smrdel, 2013, dictionary, encyclopaedia, lexicon, manual, atlas, map Abstract: Več kot tisoč dvesto žensk vsako leto zboli za rakom dojk. Ko se bolnica in njeni zdravniki po postavitvi diagnoze spopademo z boleznijo, skušamo narediti vse, da bolezen pozdravimo. Z operacijo odstranimo tumor ali celo dojko in eno ali več pazdušnih bezgavk, nato pa dojko ali področje odstranjene dojke velikokrat še dodatno obsevamo.
Keywords: hormonsko zdravljenje, stranski učinki, kemoterapija, radioterapija, metastaziranje, paliativna oskrba, klinične ratiskave
Published in DiRROS: 25.03.2019; Views: 2898; Downloads: 799
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10. Kortikosteroidi pri možganskih tumorjihNika Zorko, Tanja Roš-Opaškar, 2012, review article Abstract: Kortikosteroidi (KS) se že desetletja uspešno uporabljajo za zmanjševanje obtumorskega edema pri bolnikih z možganskimi tumorji, tako primarnimi kot metastatskimi. Kljub dolgi uporabi niso povsem znani mehanizmi njihovega delovanja v smislu na biološko in klinično učinkovitost. Deksametazon je najbolj uporabljen KS v nevroonkologiji zaradi njegovih ugodnih farmakokinetičnih, farmakodinamičnih in drugih lastnosti. Zaradi številnih možnih neželenih učinkov KS, ki lahko močno okrnijo kakovost bolnikovega življenja, uporabljamo čim nižje še učinkovite odmerke čim krajši možni čas. Številna nova tarčna zdravila za zdravljenje raka, ki zavirajo poti v procesu angiogeneze, izkazujejo učinkovitost tudi v zmanjšanju obtumorskega edema pri bolnikih z možganskimi tumorji.
Keywords: možganski tumorji, kortikosteroidi
Published in DiRROS: 31.08.2018; Views: 3298; Downloads: 763
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