Taking Personalized Medicine to a New Level: CAR-T Cell Therapy

By Martina McGrath, MD
September 13, 2017

Each individual is estimated to have around 4 x 1011 T cells, comprising many millions of T cell clones,1 each randomly produced in the thymus with a unique T cell receptor (TCR) specific for a given antigen. This massive diversity in T cell repertoire gives our immune systems the capacity to protect against the incredible array of bacteria, viruses and fungi that assail us on a constant basis. Continue reading “Taking Personalized Medicine to a New Level: CAR-T Cell Therapy”

Vancomycin as a Rare Cause of Drug-Induced Cytopenias

By Martina M. McGrath, MD
May 30, 2017

Vancomycin is a glycopeptide antibiotic, with activity against gram positive organisms, including MRSA. It is widely prescribed for hospital-acquired infections, device-related infections, and treatment of resistant organisms. While side effects such as red man syndrome, ototoxicity, and nephrotoxicity are well recognized, immune thrombocytopenia is a less common, but potentially severe, complication of vancomycin therapy. Indeed, because many affected patients are critically ill or treated with other potential culprit agents such as heparin, vancomycin-induced platelet destruction can go unrecognized. Continue reading “Vancomycin as a Rare Cause of Drug-Induced Cytopenias”

Interpreting Hemoglobin A1c in African Americans with Sickle Cell Trait

By Charbel C. Khoury, MD
March 16, 2017

Hemoglobin A1c (HbA1c) testing is mainstay in screening, diagnosis, and management of diabetes mellitus.1 Since it measures the glycation of hemoglobin occurring over the entire lifespan of a red blood cell, the HbA1c is a very practical measure for clinicians and can be used to surmise the mean blood glucose over the previous 8 to 12 weeks.2 Nonetheless, several patient-specific factors such as iron/vitamin B12/folate deficiency anemias, chronic kidney disease, cirrhosis, and erythropoietin treatment have been known to affect the reliability of this assay, due to variations in red cell turnover.2  Moreover, HbA1c levels may vary with race. In fact, numerous studies have suggested that African Americans may have higher HbA1c levels than non-Hispanic whites with the same fasting and post-glucose load glucose levels.3 Continue reading “Interpreting Hemoglobin A1c in African Americans with Sickle Cell Trait”