R.E. Kavetsky Institute of Experimental
Pathology Oncology and Radiobiology of the National
Academy of Sciences of Ukraine
All-Ukrainian Charitable Foundation
“Hematologists for Patients with Malignant Blood Disorders”
Registration No. 49606 п/к; 49607 к/м
Clinic – Scientific Center
of Radiation Medicine of the Academy
of Medical Sciences of Ukraine Chernihiv region, Kulikovsky district, village of Drozdovka
Examined: blood and bone marrow smears.
Patient name, age – Dmitruk Tatiana
Vladimirovna, born on May 20, 2001.
Morphology:
The patient has been already examined earlier (see
No. 46406-407 dated November 21, 2008)
At present the patient has marked leucopenia. Leukogram
detected 32% of blast cells of myeloid type.
In bone marrow: diffuse infiltration with monoblasts
(97%), increased number of mitosis.
Peroxidase – the reaction is negative in most
blasts and slightly positive in 8-10%.
Acid phosphatase – micro-granular reaction
Acid nonspecific esterase – strongly positive
reaction
PAS – micro-granular reaction
Acute myeloblastic leukemia
(М5а acute
myeloblastic leukemia according to FAB classification), relapse.
Chernigov Regional Children’s Hospital
Pediatric
department
Case
record
of
inpatient No. 6607
The patient was
referred to the pediatric hematology department of Scientific
Center of Radiation Medicine of the Academy of Medical Sciences
of Ukraine
Name: Dmitruk
Tatiana Vladimirovna
Patient age: born
on May 12, 2001 Address: Chernihiv region, Kulikovsky district,
village of Drozdovka, Gorkogo st. 73
Date of
hospitalization: June 09, 2009 Date of discharge: July 17, 2009
Final diagnosis:
Acute myeloblastic
leukemia,
М5а,
Second acute
period,
cardiolemia НКо
Faint
accommodation ОО
Consequence of haemorrhagic stroke - mild right-side pyramidal
insufficiency
Complete blood
count
№
|
Date
|
Hb
g/l
|
Er
*1012
|
Кол. по-каз.
|
L
*109
|
BASO
%
|
EOS.
%
|
Stab,
%
|
Segmented
,
%
|
LYM,
%
|
MON,
%
|
ESR,
mm/hour
|
PLT
*109
|
|
|
June 09
|
101
|
4.4
|
0.5
|
4.4
|
-
|
-
|
2
|
18
|
63
|
17
|
8
|
111-109
|
|
|
June 25
|
130
|
3.6
|
0.9
|
3.6
|
-
|
8
|
1
|
25
|
62
|
4
|
6
|
167-105
|
|
|
July 10
|
103
|
2.9
|
0.9
|
1.5
|
-
|
6
|
2
|
35
|
50
|
7
|
7
|
55-105
|
|
|
July 13
|
113
|
3.35
|
0.9
|
5.3
|
-
|
7
|
12
|
32
|
30
|
5
|
11
|
45-109
|
|
|
July 16
|
98
|
2.95
|
0.9
|
3.4
|
-
|
3
|
13
|
30
|
17
|
5
|
18
|
39-105
|
|
Biochemical blood
assay
№
|
Date
|
Total bilirubin, mlmol/g
|
GPT, mol/l
|
GOT, mmol/l
|
Thymol
test
|
В-lipoproteins
|
Glucose
|
С-reactive protein
|
Cholesterol
|
Cryoglobulin
|
Seromucoid
|
Blood urea
|
Creatinine
|
|
June 09
|
11.58
|
3.8
|
2.06
|
0.9
|
13
|
3.59
|
6
|
2.45
|
|
0.16
|
5.76
|
0.06
|
|
July 06
|
11.64
|
1.91
|
0.95
|
0.8
|
11
|
3.63
|
6
|
2.05
|
|
0.10
|
4.22
|
0.03
|
Proteinogram: total protein 62 g/l, 65 g/l
General urinalysis:
CSF analysis
№
|
Date
|
Cytosis
|
Protein
|
Reaction
|
|
June 16
|
1
|
0.095
g/l
|
Negative
|
|
June 30
|
1
|
0.33
g/l
|
Negative
|
|
July 07
|
1
|
0.33
g/l
|
Positive
|
|
July 14
|
1
|
0.264
g/l
|
Positive
|
ECG – mild abnormalities of ventricles’ repolarisation
EEG – corresponds to the age. Brain
CT of May 15, 2009 – atrophied focus
in left temporoparietal area.
Myelogram – dated July 15, 2009 – blasts – 97%, neutrophilic
promyelocytes – 1%, neutrophilic myelocytes – 1%, polychromatonormocytes 1%
On July 16, 2009 the smears of bone marrow were sent to the laboratory
of R.E. Kavetsky Institute of Experimental Pathology Oncology and Radiobiology
ENT (without pathology).
Oculist – faint accommodation ОО, fundus of eye is normal.
Cardiologist – cardiopathy, НКо.
Neuropathologist – consequences of haemorrhagic stroke - mild right-side
pyramidal insufficiency
Therapy: biseptol 480, erespal, hepabene, thiotriazolinum, asparkan, lanvis,
treniseptol intramuscularly;
LP with cytarabine administration of 40 mg №4, radiation therapy 18 Gy, subcutaneous
granocyte– 33.6 million IU on July 10, 2009 and July 13, 2009
REGISTRATION
CARD #7
Academy of Medical
Sciences OF UKRAINE
STATE
INSTITUTION "Scientific Center for
Radiation Medicine"
CLINIC
Kiev, pr. Peremogy 119, 121
Department
of Radiation Hematology for Children, tel.: 451-82-90
Case record of inpatient #1507
Name: Dmitruk Tatiana
Vladimirovna
AGE: born
on May 12, 2001
PLACE OF RESIDENCE: Chernihiv region,
Kulikovsky district, village
of Drozdovka, Gorkogo st,
50
DATE OF ADMISSION: November 26,
2008 DATE OF DISCHARGE: June 04, 2009
FINAL DIAGNOSIS:
Basic diagnosis: Acute myeloblastic
leukemia, M5a, the first acute period, the patient entered the stage of clinical
and hematologic remission since January 15, 2009.
Complications: Tumor lysis
syndrome. Hepatic veno-occlusive disease. Interstitial peritonitis. Hematencephalon.
Generalized vascular Bilateral lower lobe pneumonia disease. Retinal hemorrhage
in both eyes.. Left-sided pleuropneumonia. Toxic cardiopathy. Toxic hepatitis.
Concomitant diseases: Retinal angiodystonia
in both eyes. Maculopathy in the right eye.
The child was admitted to the department in grave condition (pale, intoxicated),
with marked symptoms of anasarca, hyperplasia of peripheral lymph nodes, hepatosplenomegaly.
Results of laboratory analyses
Blood group: A(II) Rh-positive blood
COMPLETE BLOOD COUNT:
Date
|
RBC
t/l
|
Hb
g/l
|
PLT
g/l
|
MCV fg
|
WBC
g/l
|
Blast cells
%
|
Promyelocytes
%
|
Myelocytes
%
|
Stab
%
|
Segmented
%
|
LYM
%
|
MON
%
|
EOS
%
|
November 26, 2008
|
1.52
|
52
|
65.0
|
92.2
|
131.2
|
42
|
45
|
3
|
3
|
2
|
3
|
2
|
-
|
November 28, 2008
|
3.33
|
99
|
54.0
|
85.0
|
173.0
|
-
|
-
|
-
|
-
|
-
|
-
|
-
|
-
|
November 30, 2008
|
2.85
|
88
|
36.0
|
88.0
|
141.3
|
-
|
-
|
-
|
-
|
-
|
-
|
-
|
-
|
December 19, 2008
|
3.03
|
98
|
27.0
|
85.8
|
7.1
|
20
|
7
|
13
|
6
|
27
|
21
|
5
|
1
|
December 26, 2008
|
3.46
|
109
|
40.0
|
88.4
|
5.16
|
-
|
2
|
3
|
3
|
50
|
42
|
|
-
|
January 03, 2009
|
2.81
|
88
|
21.0
|
85.3
|
1.91
|
-
|
-
|
-
|
-
|
-
|
96
|
2
|
2
|
June 01, 2009
|
2.85
|
84
|
117.0
|
84.9
|
2.5
|
-
|
-
|
-
|
-
|
15
|
75
|
10
|
-
|
biochemical blood assay: AT ADMISSION: total protein 55 g/l, glucose 4.4 mmol/l, total bilirubin 5.8 μmol/l, blood urea 6.5 mmol/l, creatinine 119.9 μmol/l, GPT 12 unit/l, GOT 37 unit/l. Alkaline phosphatase 155 μkat/l, LDH 1398.0 unit/l. Cholesterol 2.1 μmol/l, Albumins -48.2%, Globulins -51.8%, α1-globulin - 2.7%, α2-globulin
- 12.8%, β-globulin - 10.3%, γ-globulin - 26.0%, protein index - 0.93. Creatine phosphokinase - 29 unit/l.
December 07, 2008 - total protein 50.8 г/л, total bilirubin 102.8 μmol/l, GPT 15.7 unit/l, GOT 17.2 unit/l.
December 28, 2008 - total protein 74.7 g/l, total bilirubin 17.9 μmol/l,
GPT 14.2 unit/l, GOT 17,4 unit/l.
May 31, 2009 - total protein 63.4 g/l, glucose 5.3 mmol/l, total
bilirubin 8.4 μmol/l, blood urea 3.3 mmol/l, creatinine 60.3 μmol/l, GPT 77.6 unit/l,
GOT 43.1 unit/l.
myelogram: dated January 15, 2009: number
of myelokariocytes – 100.0 g/l, blast cells – 1.6%, promyelocytes – 1.4%, myelocytes
– 17.6%, immature – 5.6%, stab – 10.0%, segmented – 8.6% basophils – 0.2, eosinophils - 0%, lymphocytes 1.6%, monocytes
- 11,0%,
erythroblasts – 0.6%, normocytes: basophilic – 4.8%, polychromatophilic – 4.4%,
oxyphilic -1.4%, total erythroid cells – 24.4%, megacaryocytes 5/10 per HPF, forms
of mitosis – 0.2.
myelogram: dated February 17, 2009: number
of myelocariocytes – 60.0 g/l, blast cells – 1.2%, promyelocytes – 0.6%, myelocytes
– 6.2%, immature – 4.0%, stab – 10.0%, segmented – 10.0% basophils – 0.2, eosinophils – 0.2%, lymphocytes -15.2%, monocytes – 21.2%,
erythroblasts – 0.4%, normocytes: basophilic – 1.8%, polychromatophilic – 8.2%,
oxyphilic – 14.8%, total erythroid cells - 25.2%, megacaryocytes 5/10 per HPF.
myelogram: dated March 20, 2009: number
of myelocariocytes – 160.0 g/l, blast cells – 1.0%, promyelocytes – 0.8%, myelocytes
– 7.2%, immature – 4.8%, stab – 14.2%, segmented – 18.0% promonocytes14%, eosinophils
– 0.4%, lymphocytes – 5.0%, monocytes
- 7.6%,
erythroblasts – 1.2%, normocytes: basophilic – 4.8%, polychromatophilic – 11.6%,
oxyphilic – 22.0%, total erythroid cells – 39.6%, megacaryocytes 4/10 per HPF.
myelogram: dated April 30, 2009: number
of myelocariocytes – 170.0 g/l, blast cells – 5.4%, promyelocytes – 1.6%, myelocytes
– 8.2%, immature – 4.4%, stab – 13.4%, segmented – 17.4% basophils - 0%, eosinophils – 0.4%, lymphocytes - 16.8%, monocytes – 6.4%,
erythroblasts – 1.6%, normocytes: basophilic – 1.6%, polychromatophilic – 6.4%,
oxyphilic – 16.4%, all erythroid – 26.0%, megacaryocytes 2/10 per HPF.
myelogram: dated June 02, 2009: number of
myelocariocytes – 130.0 g/l, blast cells – 1.4%, promyelocytes – 1.2%, myelocytes
– 5.4%, immature – 2.0%, stab – 10.8%, segmented – 11.0% basophils - 0.6%, eosinophils - 0.2%, lymphocytes - 11.2%, monocytes
– 7.8%,
erythroblasts – 0.8%, normocytes: basophilic – 4.2%, polychromatophilic – 13.2%,
oxyphilic - 30.4%, all erythroid – 48.6%, megacaryocytes 3/10 per HPF, forms of
mitosis – 0.2.
DNA TESTING: Expression of BCR/ABL chimeric gene is not detected in the
cells of bone marrow and peripheral blood.
Cytogenetic testing: Colonial karyotype
abnormalities are not detected.
immunoassay: Ig - 1.78 g/l, IgG - 9.49 g/l,
IgM - 0.92 g/l, circulating immune complex – 4.166% - 5 units of optical dense,
circulating immune complex 7.2% - 90 units of optical dense.
anti-infective immunity: HBs AG – negative,
RW – negative, anti-HCV – positive 26, anti CMV, IgG – positive 4.26, anti-Toxo, IgG – negative,
anti HSV, IgG – positive 1.77, Epstein-Barr virus NA IgG positive 2.47.
Bacteriological analysis of blood: bacteremia is not
detected.
Bacteriological analysis of the pharynx and
nose mucous membranes swabs:
pharynx – heavy increase of S.epidermidis, moderate increase of Str.viridans,
moderate increase of Ent.Faecium.
Nose – microflora is not detected.
examination OF cerebrospinal fluid: dated December 04,
2009 transparent, cytosis 1.2 х3 mm3, dated December
11, 2008 cytosis 72х3 mm3 (RBC),
protein 0.099 g/l, dated December 12, 2008 slightly turbid, protein 0.264 g/l, cytosis
8.4х3 mm3 , microscopy:
invariable RBC, dated December 16, 2008 protein 0.165 g/l, cytosis 1.2 х1 mm3 , dated December
23, 2008 number 1.5 ml, transparent, protein 0.066 g/l, cytosis 4.8х3 mm3 , dated December
30, 2008 number 0.7, transparent, cytosis 6.6 х3 mm3 , protein 0.066 g/l, dated January 06,
2009 transparent, protein 0.099 g/l, cytosis 2.2х1 mm3 , dated January 15. 2009 slightly turbid,
protein 0.066 g/l, cytosis 3.6х1
mm3 , dated January 25, 2009 transparent, protein 0.1 g/l, cytosis 3.9
х3 mm3 , dated
February 21, 2009 transparent, protein 0.066 g/l, cytosis 2 х3 mm3 , dated May 05,
2009 cytosis 3.6 в 1 μl transparent, protein 0.099 g/l,
от June 02, 2009
cytosis 1 in
1 μl transparent, protein
0.099 g/l.
Clinical urinalysis: no changes.
Feces for egg/helminth: egg/helminth and protozoa
are not detected.
RESULTS
OF instrumental examination
ECG: Rhythm – sinus tachycardia, vertical position
of the electrical heart axis, vertical electric position, systolic overloading
of the left atrium, predominance
of the left
ventricle, abnormalities of myocardium repolarisation processes in the segment
of posterior wall of the left ventricle.
Ultrasonic examination of the visceral
organs:
dated November 26, 2008. Liver: 124х51 mm, enlarged, tissue echogenicity retained,
homogeneous structure, granular pattern, bile ducts are free, portal system is
not dilated 7 mm.
Gallbladder is enlarged, extended, folded in the lower third (67х20 mm), wall up to 2 mm. Pancreas: 23х13х20 mm, thickened, tissue
echogenicity retained, the structure is heterogeneous because of the small
hyperechoic segments, the border is even, no focal changes. Spleen: enlarged 156х56 mm, homogeneous, splenic
vein is not dilated. The right kidney: 135х50 mm, parenchyma 17 mm, enlarged, echogenicity
of parenchyma is moderately enlarged, hollow system is expanded. Pelvicalyceal
system deformed, the left kidney: 119х43 mm, parenchyma 15 mm, is not enlarged, echogenicity
of parenchyma is moderately enlarged, hollow system not expanded, Pelvicalyceal system deformed,
single hyperechoic formations of 1
mm on both sides. In the area of small pelvis small
amount of free liquid is visualized, in the left lower flange of the abdominal
cavity free liquid is detected sized 46х16 mm.
Dated June 01, 2009 г. Liver:
117х40 mm, enlarged,
tissue echogenicity is retained, homogeneous structure, granular pattern, bile
ducts are free, portal system is not dilated 8 mm. Gallbladder is enlarged,
folded in the neck (68х13mm), the wall is up to 1- 2 mm. Pancreas: 23х12х29 mm, thickened, tissue
echogenicity is retained, the structure is heterogeneous because of the small
hyperechoic segments, the border is even, no focal changes. Spleen: is not
enlarged 114х35 mm, homogeneous,
splenic vein is not dilated. The right kidney: 104х32 mm, parenchyma 13 mm, the left kidney: 94х37 mm, parenchyma 16 mm, single hyperechoic
formations of 1 mm
on both sides.
thyroid gland ultrasound: is located in
typical place, not enlarged, isthmus of gland is not thickened, capsule is not
thickened, the border is even, echogenicity without changes, echostructure is
homogeneous, right lobe is 43х8х13 mm, V – 2.14 cm3,
left lobe is 41х9х13 mm, V- 2.29 cm3.
HEART ultrasound: aorta, aortic
valve – moderately thickened. Mitral valveas are not changed. Cardiac chambers are not dilated. Hypertrophy
of the left ventricle walls is not detected. Myocardium contractility is
increased (ejection fraction – 67%). Exudate is absent. Laparocentesis
dated December 04, 2008. 1
liter of exudate is taken out.
CHEST X-RAY – dated December 10, 2008: the signs of the lower lobe
pneumonia in the right, lower lobe pleuropneumonia in the left.
CHEST X-RAY – dated October 19, 2008: the signs of the bilateral lower
lobe pneumonia, left-sided exudative pleurisy.
CHEST X-RAY – dated January 05, 2008: the signs of the bilateral lower
lobe pneumonia in the stage of resolution.
CHEST X-RAY – dated February 25, 2009 – lung pattern in root areas is
intensified because of the peribronchial component. Roots of lungs are
anhistous, intensified at the expense of vascular component. Cardiovascular marking is not dilated.
Consultations
Cardioreumatologist – secondary
cardiopathy.
Dentist
– caries. Chronic periodontitis.
Ophthalmologist – dated
February 24, 2009. Retinal hemorrhage in both eyes. Dated 03, 2009. Retinal angiodystonia
in both eyes. Masculopathy in the right eye.
Received
treatment: according to protocol BFM -2002 AML (. The stage of cytoreduction (hydroxyurea)
started since November 26, 2008; therapy with cytosar 40 mg/m2 daily
since December 01, 2008, the therapy of AIE block started since December 03, 2008,
HAM, AI, hAM, HAM blocks), antimicrobial, fungicide, antiviral therapy,
haemostatic therapy, blood products transfusion: (packed red cells A (II) positive
№ 19, platelet concentrate № 32, fresh frozen plasma №6), infusion and symptomatic therapy.
RECOMMENDATIONS:
1.
Haematologist supervision at the place of
residence.
2. Dietotherapy, diet # 5.
3. Control of complete blood count, biochemical blood assay.
4. Brain CT with
vascular enhancement.
5. Brain irradiation (cumulative dose 18 Gy) with four intrathecal
administrations of cytarabine (days 1, 15, 21, 28 from the beginning of
irradiation) simultaneously with supportive therapy: 6-thioguanine
40 mg/m2 daily with four day blocks of cytarabine monthly (40 mg/m2
in 24 hours subcutaneous). Dose
adjustment of 6-thioguanine: WBC level > 3000/mm3 – 150%. >2000/mm3
– 100%, >1000/mm3 – 50%, <1000/mm3 – 0%.
6. Ophthalmologist prescription – lutein-complex 1 tablet once daily for 2
month.
The patient has not
been in contact with a contagious patient
ATTENDING DOCTOR signature
(Gonchar L.O.)
CHIEF OF DEPARTMENT
signature
(Kuznetsova O.E.)
DEPUTY HEAD DOCTOR signature
(Kolos V.I.)
THE MINISTRY OF HEALTH
OF UKRAINE
NATIONAL CHILDREN
CLINICAL HOSPITAL “OHMATDYT”
01135, Kyiv tel.:+38-(044)-236-02-14
Chornovola str., 28/1 fax/tel.:
+38-(044)-236-42-15
Sholudenko str., 10
September
26, 2009.
CONSULTATIVE
CONCLUSION
Patient: Dmytruk Tatyana Vladimirovna
DOB: May 12, 2001.
Home address: Kulikovsky Region, Chernigiv
Oblast.
Diagnosis: acute myeloid leukemia (M5a – by the
results of morpho-cytochemical examination). The Ist early bone marrow relapse.
Considering the relapse character, in case of complete or at least partial secondary remission the girl
has an absolute indication for
transplantation from unrelated HLA-compatible or partially compatible family
donor abroad (outside of Ukraine).
Director of Center of Children
Oncology, Hematology
and Bone Marrow Transplantation (DOG TKM
Center)
Chief Children Hematologist
of the Ministry of Health of Ukraine (Signature) S.
Donskaya
REGISTRATION CARD #7
Academy of Medical
Sciences OF UKRAINE
STATE
INSTITUTION "Scientific Center for
Radiation Medicine"
CLINIC
Ukraine, Kiev,
pr. Peremogy 119, 121
Department of Radiation
Haematology for Children, tel.: +38 044 451 82 90
Case
record of inpatient #911
Name: Dmitruk
Tatiana Vladimirovna
DOB: May 12, 2001
PLACE OF RESIDENCE: Chernigov region,
Kulikovsky district, village
of Drozdovka, Gorkogo st,
50
DATE OF ADMISSION: July 17, 2008 DATE OF DISCHARGE: UP TO THE PRESENT MOMENT
FINAL DIAGNOSIS:
Main: Acute myeloblastic leukemia,
M5a, bone-marrow recurrence.
Complications: myelosuppression of IV stage. Febrile neutropenia.
Transient cholestasis. Right-sided lower lobe pneumonia.
Concomitant diseases: retinal angiodystonia of both eyes.
The child was admitted to the department in grave condition (pale, intoxicated),
severe skin hemorrhagic syndrome, peripheric lymph nodes and spleen are not
enlarged, liver is + 2.5 cm
lower costal arch. After receiving FLAG-Mito anti-relapse course, the
bone-marrow remission was not achieved.
LABORATORY
REPORT
BLOOD
GROUP: A(II) RH POSITIVE
COMPLETE BLOOD COUNT:
Date
|
RBC
t/l
|
Hb
g/l
|
PLT
g/l
|
MCV
fg
|
WBC
g/l
|
Blast cells
%
|
Promyelocytes
%
|
Myelocytes
%
|
Stab
%
|
Segmented
%
|
LYM
%
|
MON
%
|
EOS
%
|
June 17-2009
|
2.98
|
92
|
10.0
|
98.5
|
4.61
|
24
|
6
|
2
|
13
|
30
|
17
|
5
|
3
|
September 02 - 2009
|
2.15
|
70
|
56
|
86.5
|
6.8
|
34
|
2
|
4
|
3
|
52
|
2
|
3
|
-
|
biochemical blood assay: Sept 01, 2009: total protein 66 g/l, glucose
3.8 mmol/l, total bilirubin 6.0 μmol/l, blood urea 3.8 mmol/l, creatinine 65.0
μmol/l, GPT 196 unit/l, GOT 50 unit/l, ALP 179 μkat/l.
bacterial
examination OF BLOOD: bacteremia is not detected.
bacterial
examination OF swab FROM throat AND NOSE mucous membrane:
Throat – microflora is not detected.
Nose – microflora is not detected.
examination
OF cerebrospinal fluid: of Jjuly
17, 2009 – transparent, cytosis
3.7 x 3 mm3, protein 0.090 g/l.
General
urinE alysis: no changes.
RESULTS OF instrumental examination
ECG: rate – sinus tachycardia, vertical
position of the electrical axis of heart, vertical electric position,
enlargement of left atrium, left ventricle with no abnormality, not evident myocardial
changes, more evident in the posteroanterior wall of the left ventricle.
abdominal
ultrasound: liver – 116 x 41 mm,
enlarged, tissue echogenicity is retained, homogeneous structure, granular
pattern, bile ducts are free, portal system is not dilated 7 mm. Gallbladder is enlarged,
extended, folded in the neck (70 x 19 mm), the wall is up to 1 mm. Pancreas: 24 x 14 x 25 mm, thickened, tissue echogenicity
is retained, the structure is heterogeneous because of the small hyperechoic
segments in the tail segments, the border is even, no focal changes. Spleen:
enlarged 135 x 54 mm,
homogeneous, splenic vein is dilated 10 mm. The right kidney: 115 x 33 mm, parenchyma 15 mm, is not enlarged, echogenicity
is retained, the left kidney: 111 x 36 mm, parenchyma 15 mm, is not enlarged, parenchyma
echogenicity is retained, hollow system is not expanded, single hyperechoic
formations of 1 mm
on both sides.
HEART ultrasound:
valves are not changed. Chambers of heart are not dilated. Hypertrophy
of the left ventricle walls is not detected. Myocardium contractility is increased
(ejection fraction – 62%). No effusion. Apical additional transversal chorda of
the left ventricle.
CHEST X-RAY of August 07, 2009:
signs of the right-sided lower lobe pneumonia.
Consultations
Surgeon – there are no signs of acute surgical pathology.
Neurologist – no pathology.
Ophthalmologist – retinal angiodystonia of both eyes.
THERAPY GIVEN: FLAG-Mito anti-relapse
course, antimicrobial, fungicide, antiviral therapy, haemostatic therapy, blood
products transfusion, fluid and supportive therapy.
The case record is given per mother’s request.
ATTENDING DOCTOR [signature] (Gonchar L.O.)
DEPARTMENT CHIEF [signature] (Kuznetsova O.E.)
ASSISTANT HEAD DOCTOR [signature] (Kolos V.I.)
September 03, 2009
[Seal]
Ukraine, State Institution
“Scientific Center for Radiation Medicine”
Academy of Medical Sciences OF UKRAINE
Identification code 048378335
Clinic
Academy of Medical
science of Ukraine
Scientific centre of
Radiation medicine
53 Melnikova street, Kiev, 25405, Ukraine
Phone 483 0637, 483
9215.
Fax 483 7202
Laboratory of immune
genetics
July, 31, 2009
The results of molecular HLA – genotype
№
|
Name
|
Patient
|
HLA – class I
|
HLA – class II
|
HLA-A*
|
HLA-B*
|
HLA-Cw*
|
HLA-DRB1*
|
HLA-DRB__*
|
HLA-DQA1*
|
HLA-DQB1*
|
3061 - H
|
Dmytruk Tetyana Volodymyrivna
|
Recipient
|
02
02
|
13
13
|
06
06
|
07
07
|
4
4
|
0201
0201
|
0202
0202
|
3086 – H
|
Maslova Iryna Volodymyrivna
|
Donor-mother
|
02
68
|
13
27
|
01
06
|
07
14
|
4
3
|
0104
0201
|
0202
050301
|
3091 - H
|
Dmytruk Volodymyr Mykhaylovych
|
Donor-father
|
02
29
|
13
44
|
06
06
|
07
07
|
4
4
|
0201
0201
|
0202
0202
|
The
molecular genetic research was conducted with SSP method
Birth
certificate
Citizen of Ukraine
Dmuytruk Tetyana Volodymyrivna
was born May, 12, 2001.
The birthplace is Drozdivka village, Kulikovskyi region,
Chernihiv district.
The act of birth was denoted under the number 4
on August, 2, 2001 in
the Book of civil acts of birth statement.
Parents:
Father: Dmytruk Volodymyr Mykhaylovych, citizen of Ukraine
Mother: Maslova Iryna Volodymyrivna, citizen of Ukraine
Place of registration:
Executive
Committee of Drozdiv village council, Kulikovskyi region, Chernihiv district.
Date of issue:
September, 27, 2001
|