Contact

  • Academic
    rorkusya@stanford.edu
    University - Scholar Department: Pediatrics Position: Medical Fellow
    University - Incoming student Department: Epidemiology and Population Health Position: Graduate

All Publications

  • B-lymphoblastic leukemia with transient spontaneous remission in the setting of severe group A streptococcus infection. Journal of hematopathology Gilbert, A., Tan, J., Nadimpalli, S., Orkusyan, R., Fernandez, Z. I., Oak, J., Fernandez-Pol, S. 2023; 16 (4): 223-226

    Abstract

    Spontaneous remission of B-lymphoblastic leukemia (B-ALL) in the setting of viral and bacterial infections has been reported. Here, we present a case of B-ALL that showed a complete remission in the setting of group A streptococcal bacteremia. The patient was an 11-year-old boy who presented with a sore throat, right ear pain, and rhinorrhea. Prior to the diagnosis of B-ALL, he was diagnosed with streptococcal pharyngitis and received a single dose of dexamethasone and azithromycin. One day later, he was found to be pancytopenic and an immunophenotypically abnormal B-lymphoblastic population was detected comprising 0.6% and 16.8% of the peripheral blood and bone marrow cells, respectively. Though a diagnosis of B-ALL was highly suspected, blast percentage was <20% and the bone marrow showed relatively unremarkable trilineage hematopoiesis. On close monitoring, the suspected neoplastic population became undetectable by day 17 and the patient's complete blood count (CBC) completely normalized by day 46. On day 82, a peripheral blood smear demonstrated circulating blasts. Flow cytometry of a bone marrow aspirate revealed B-lymphoblastic leukemia accounting for 94% nucleated cells, consistent with the diagnosis of B-lymphoblastic leukemia. This case is of interest as less than 20 examples of spontaneous remission of B-ALL have been reported in the literature. As the case reported here relapsed and previously reported spontaneously remitting cases have uniformly relapsed, cases of B-ALL with spontaneous remission should be followed very closely for recurrence.

    View details for DOI 10.1007/s12308-023-00564-5

    View details for PubMedID 38175433

    View details for PubMedCentralID 3309707

  • Fusarium and Lomentospora co-infection in a pediatric patient with acute myelogenous leukemia: When Occam's razor may not always apply. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases Mah, J., Orkusyan, R., Joerger, T., Banaei, N. 2022

    View details for DOI 10.1016/j.ijid.2022.11.019

    View details for PubMedID 36410692

  • Lack of mycothiol and ergothioneine induces different protective mechanisms in Mycobacterium smegmatis. Biochemistry and biophysics reports Singh, A. R., Strankman, A., Orkusyan, R., Purwantini, E., Rawat, M. 2016; 8: 100-106

    Abstract

    Mycobacterium smegmatis contains the low molecular weight thiols, mycothiol (MSH) and ergothioneine (ESH). Examination of transposon mutants disrupted in mshC and egtA, involved in the biosynthesis of MSH and ESH respectively, demonstrated that both mutants were sensitive to oxidative, alkylating, and metal stress. However, the mshC mutant exhibited significantly more protein carbonylation and lipid peroxidation than wildtype, while the egtA mutant had less protein and lipid damage than wildtype. We further show that Ohr, KatN, and AhpC, involved in protection against oxidative stress, are upregulated in the egtA mutant. In the mshC mutant, an Usp and a putative thiol peroxidase are upregulated. In addition, mutants lacking MSH also contained higher levels of Coenzyme F420 as compared to wildtype and two Coenzyme F420 dependent enzymes were found to be upregulated. These results indicate that lack of MSH and ESH result in induction of different mechanisms for protecting against oxidative stress.

    View details for DOI 10.1016/j.bbrep.2016.08.006

    View details for PubMedID 28220152

    View details for PubMedCentralID PMC5315357