Department of Haematology
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Item Chronic myeloid leukaemia in an adult Ghanaian with sporadic neurofibromatosis 1(Indian Journal of Dermatology, 2011) Olayemi, E.E.; Benneh, A.A.; Acquah, M.E.; Mensah, P.K.Patients with neurofibromatosis type 1 (NF1), a common, progressive, autosomal dominant neurocutaneous disorder, are predisposed to malignancies. Several types of hematologic malignancies have been described in them. However, to date there has been no report to the best of our knowledge of a patient with NF1 developing chronic myeloid leukemia (CML). We present an adult Ghanaian with NF1, who subsequently developed CML. Relevance of the case report is discussedItem Presence of lupus anticoagulant in an asymptomatic Nigerian(African Health Sciences, 2007) Olayemi, E.E.; Bazuaye, G.N.Background The lupus anticoagulant (LA) is one of the antiphospholipid antibodies (aPL), which prolong phospholipid- dependent coagulation tests by interfering with coagulation reactions that depend on protein - phospholipid complexes in vitro. Method A 25 year old ‘healthy’ male Nigerian was screened for the presence of any coagulation abnormality using the KCT, PT and platelet count; after volunteering for his plasma to be used in the preparation of normal pooled plasma in a study. Results He was discovered to have a prolonged KCT, PT and normal platelet count. Based on the prolonged KCT his plasma was subjected to mixing studies with various concentration of normal pooled plasma; the KCT index was calculated and a curve was plotted. His KCT index was 1.6 and the curve convex in the left axis suggesting the presence of LA. His past medical history and physical examination were not remarkable. Three months after the initial study, a repeat KCT index was 1.4 and the subject asymptomatic. Conclusion From literature review this is the first report of LA in an asymptomatic adult Nigerian; the importance of this finding is discussed.Item Lupus anticoagulant and leg ulcers in sickle cell anemia(Indian Journal of Dermatology, 2009) Olayemi, E.E.; Bazuaye, G.N.Background: The cause of chronic leg ulcer (CLU) in patients with sickle cell anemia (SCA) is unknown; it has been attributed to hypercoagulability associated with the disease. Recently, it has been suggested that a subset of SCA patients may be prone to developing CLU and that hemolysis may be an underlying factor in the development of CLU. The lupus anticoagulant (LA) is an antiphospholipid antibody (aPLa), these antibodies have been described in patients with SCA. Aims: This study was designed to determine the frequency of LA in SCA patients with CLU compared with those without CLU. Materials and Methods: Study design is a descriptive, cross-sectional one. Thirty-three SCA patients with CLU and 33 patients without CLU were screened for the presence of LA using the Kaolin clotting time (KCT), which is an important assay, and Kaolin clotting time index was calculated. Means were compared using the students' t test, proportions were compared using the chi-square test, level of significance was set at 0.05, odds ratio was calculated. Results: About 18.18% of patients with CLU had LA, compared with 6.06% among controls ( P < 0.05); odds ratio was 3.44 (95% CI 0.64 - 18.51). Conclusions: We conclude that SCA patients with CLU may be more likely to develop LA, and this may be related to the degree of hemolysis. Further studies are required to find out if CLU and LA are a result of hemolysis or if LA is responsible for the higher incidence of hemolysis and CLU found among these patientsItem Lupus anticoagulant in human immunodeficiency virus -infected patients on highly active antiretroviral therapy(Indian Journal of Pathology and Microbiology, 2010) Awodu, O.A.; Olayemi, E.E.; Bazuaye, G.N.; Onunu, A.N.Lupus anticoagulant (LA) is a heterogeneous group of antibodies that causes a variety of clinical and laboratory effects; has been described in infections such as human immunodeficiency virus. LA has not been previously described in Nigerians with human immunodeficiency virus infection on highly active antiretroviral therapy (HAART). Aim: To determine the frequency of LA in patients infected with the human immunodeficiency virus on HAART. Methods: Cross sectional study of patients with human immunodeficiency virus infection undergoing HAART at a tertiary hospital in Nigeria. Screening for LA was done using the activated partial thromboplastin time (aPTT) and kaolin clotting time (KCT). Mixing experiments were conducted on samples with prolonged clotting time. KCT ratio was calculated. A positive result was taken as KCT ratio greater than or equal to 1.2. Fisher's exact test was used to test the association between LA and sex. Association between aPTT and KCT was tested according to Pearson. P-value < 0.05 was considered significant. Results: Fifty-eight patients aged 18- 60 years were studied, comprising of 28 males (mean age 40.50 plus/minus 8.8 years) and 30 females (mean age 35.4 plus/minus 9.02). Frequency of LA among human immunodeficiency infected patients was 5.2%, (frequency in males and females were 3.6 and 6.7 % respectively). This was lower than 46% reported in patients not on HAART. There was no statistically significant difference in LA prevalence between males and females P greater than0.05. A positive correlation was observed between the clotting tests aPTT and KCT (r is equal to 0.9406, p less than 0.0001). Conclusion: HAART may prevent development of LA in HIV-infected patientsItem Lupus anticoagulant in human immunodeficiency virus -infected patients on highly active antiretroviral therapy(Medknow Publications, 2010) Awodu, O.A.; Olayemi, E.E.; Bazuaye, G.N.; Onunu, A.N.BACKGROUND: Lupus anticoagulant (LA) is a heterogeneous group of antibodies that causes a variety of clinical and laboratory effects; has been described in infections such as human immunodeficiency virus. LA has not been previously described in Nigerians with human immunodeficiency virus infection on highly active antiretroviral therapy (HAART). AIM: To determine the frequency of LA in patients infected with the human immunodeficiency virus on HAART. METHODS: Cross sectional study of patients with human immunodeficiency virus infection undergoing HAART at a tertiary hospital in Nigeria. Screening for LA was done using the activated partial thromboplastin time (aPTT) and kaolin clotting time (KCT). Mixing experiments were conducted on samples with prolonged clotting time. KCT ratio was calculated. A positive result was taken as KCT ratio greater than or equal to 1.2. Fisher's exact test was used to test the association between LA and sex. Association between aPTT and KCT was tested according to Pearson. P-value < 0.05 was considered significant. RESULTS: Fifty-eight patients aged 18- 60 years were studied, comprising of 28 males (mean age 40.50 plus/minus 8.8 years) and 30 females (mean age 35.4 plus/minus 9.02). Frequency of LA among human immunodeficiency infected patients was 5.2%, (frequency in males and females were 3.6 and 6.7 % respectively). This was lower than 46% reported in patients not on HAART. There was no statistically significant difference in LA prevalence between males and females P greater than0.05. A positive correlation was observed between the clotting tests aPTT and KCT (r is equal to 0.9406, p less than 0.0001). CONCLUSION: HAART may prevent development of LA in HIV-infected patients.Item Leg ulcers in adult sickle cell disease patients in Benin City Nigeria(2010) Bazuaye, G.N.; Nwannadi, A.I.; Olayemi, E.E.Background: Chronic leg ulceration is the most common cutaneous manifestation of sickle cell disease. In this study we observed adult sickle cell disease patients with leg ulcer. Methodology: In this observational study, patients with sickle cell disease at University of Benin Teaching Hospital and Sickle Cell Centre Benin, from July 2008 to June 2009 were recruited. After informed consent 273 patients were selected but only 250 (125 males and 125 females) were interviewed and completed a pre-tested questionnaire. Data included socio-demographic information, history of previous leg ulcers and current ulcers confirmed by examination. In those currently with leg ulcers, haemoglobin phenotype, stable haemoglobin (calculated as average haemoglobin in the absence of vaso-occlusive crises in past 3 months, site, diameter and status of leg ulcers were documented. Data were analyzed using SPSS version 11. Results: In sickle cell disease patients leg ulcers were found currently in 24(9.6%) and previously in 56(22.4%), while in sickle cell trait it was 0% and 2(0.8%) respectively. Leg ulcers were more prevalent in males than females (M:F=3:1), in those with lower stable haemoglobin 6.1–8g/dl (58.4%), age range of 18-25 years (66.7%), around left lateral ankle (66.7%) and with average diameter of 5-10cm (58.4%). Aetiology was mainly traumatic (58.4%) with 33.4% as traditional traumatic scarification. Greater than one year recurrence was 50%, and ulcers were septic in 83.4%. Conclusion: A lower stable haemoglobin, ignorance and poverty play important role in worsening chronic leg ulcers in sickle cell disease. Improved health education, prompt medical and surgical intervention could improve these leg ulcers.Item Lupus anticoagulant in human immunodeficiency virus–infected patients on highly active antiretroviral therapy(Indian J Pathol Microbiol 53(1): 47-9, 2010) Awodu, O.A.; Olayemi, E.E.; Bazuaye, G.N.; Onunu, A.N.Lupus anticoagulant (LA) is a heterogeneous group of antibodies that causes a variety of clinical and laboratory effects; has been described in infections such as human immunodeficiency virus. LA has not been previously described in Nigerians with human immunodeficiency virus infection on highly active antiretroviral therapy (HAART).