Browsing by Author "Costa, Y.J."

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Chronic myeloid leukaemia with generalized lymphadenopathy – a high risk category
(The Sri Lanka College of Haematologists, 2022) Prasanni, W.D.D.; Williams, H.S.A.; Costa, Y.J.; Dissanayake, T.
Chronic myeloid leukaemia (CML) presenting with generalized lymphadenopathy is an uncommon manifestation of CML. Lymphadenopathy in these patients could be due to extramedullary involvement by myeloid cells with all stages of maturation, blast infiltration, co-existing lymphoproliferative disorder or reactive lymphadenopathy. We report a case of a 38-year-old male with CML in chronic phase and generalized lymphadenopathy at diagnosis. He transformed to blast crisis within 14 weeks of diagnosis despite tyrosine kinase inhibitor (TKI) therapy. This case indicates that CML patients with lymphadenopathy are at high risk of disease progression and early blast transformation and therefore candidates for aggressive treatment.
A descriptive study of anaemia in the elderly at a tertiary care institute in Sri Lanka
(The Sri Lanka Medical Association, 2022) Chathurangani, K.C.; Darshana, L.G.T.; Premathil, R.A.; Costa, Y.J.; Amarasekara, A.A.D.S.; Premawardhena, A.P.
INTRODUCTION: Anaemia is a commonly encountered condition among the elderly population which calls for further evaluation to identify the cause and to prevent complications.OBJECTIVES: To determine the prevalence, causes and complications related to anaemia among elderly patients admitted to two medical wards (15/16) of Colombo North (Teaching) Hospital, Ragama, Sri Lanka.METHODS: Patients aged over>65 years admitted to the above wards between April –Sep 2020 and who had anaemia were included in the study. Clinical and nutritional data were collected using an interviewer-administered questionnaire. Laboratory findings were extracted from hospital records.RESULTS: The majority of the patients were females (63.2%; n = 129). The mean age was 72.5 years (65 – 92 years). Most of the patients (62.3%; n = 127) were symptomatic for anaemia at the time of hospital admission. The majority of the participants (75.5%; n = 154) did not demonstrate any complications related to anaemia. The severity of the anaemia was moderate among more than half of the patients (52.5%; n=107). Anaemia of chronic disease (54.4%; n=111) was the commonest etiological category detected. The majority of the cases with anaemia of chronic disease were due to chronic renal insufficiency (73.9%; n=82). The severity of the anaemia increased significantly with the presence of chronic disease (p 0.030).CONCLUSION: Most patients in the present study had moderate anaemia whilst anaemia of chronic disease was the leading aetiological class contributor. Community-based studies are needed to understand the true burden of anaemia in the ageing population in Sri Lanka.
Splenic Syndrome in a young man at high altitude with undetected Sickle Cell Trait
(Sage, 2018) Fernando, C.H.K.A.; Mendis, S.; Upasena, A.P.; Costa, Y.J.; Williams, H.S.A.; Moratuwagama, D.
INTRODUCTION: Splenic syndrome is a rare presentation of sickle cell disease. It is important to rule out this possibility when an ethnically vulnerable patient presents with an acute abdominal symptoms in a background of precipitating events. CASE REPORT: A 26-year-old man who developed a severe abdominal pain at high altitude, found to have a tender splenomegaly. However, further inquiry revealed he is from an area where sickle cell disease is prevalent. Screening for sickle cell disease was positive. Radiological investigations confirmed a massive splenic infarction keeping with a diagnosis of splenic syndrome. Patient was managed conservatively. CONCLUSION: Sickle cell trait is considered a benign carrier state. However, rarely they can present with life-threatening conditions. Therefore, a high degree of clinical suspicion is required for early diagnosis of these specific entities to avoid increased morbidity and mortality of these patients.