Pediatric Infection and Vaccine

  • 제20권3호
  • /
  • Pages.178-185
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  • 2013
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  • 2384-1079(pISSN)
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  • 2384-1087(eISSN)
대한소아감염학회 (The Korean Society of Pediatric Infectious Diseases)
권호 표지

호흡기바이러스 감염에 의한 혈액학적 합병증

Hematologic Complication of Respiratory Virus Infection

  • 박인호 (원광대학교 의과대학 소아과학교실) ;
  • 이수호 (원광대학교 의과대학 소아과학교실) ;
  • 유승택 (원광대학교 의과대학 소아과학교실) ;
  • 최두영 (원광대학교 의과대학 소아과학교실)
  • Park, In Ho (Department of Pediatrics, Wonkwang University College of Medicine) ;
  • Lee, Su Ho (Department of Pediatrics, Wonkwang University College of Medicine) ;
  • You, Sung Taek (Department of Pediatrics, Wonkwang University College of Medicine) ;
  • Choi, Du Young (Department of Pediatrics, Wonkwang University College of Medicine)
  • 투고 : 2013.02.03
  • 심사 : 2013.06.20
  • 발행 : 2013.12.25
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초록

목적: 다양한 바이러스 감염이 혈액학적 합병증, 특히 빈혈, 호중구 감소증 및 혈소판감소증과 같은 혈구 감소증을 일으킨다. 그러나 최근 호흡기 바이러스에 의한 혈액학적 합병증에 대해서는 제한적으로 보고되었다. 따라서 저자들은 호흡기 바이러스 양성 환자들을 대상으로 혈액학적 합병증과 그 임상 경과를 평가하기 위해 본 연구를 시행하였다. 방법: 2011년 10월부터 2012년 3월까지 6개월 동안 원광대학병원 소아청소년과에 입원한 496명의 소아청소년에서 호흡기 바이러스 multiplex reverse transcription polymerase chain reaction 결과와 혈액학적 소견을 후향적으로 분석하였다. 결과: 대상 환자 중 379명에서 호흡기 바이러스가 검출 되었다. 가장 흔한 바이러스는 respiratory syncytial virus (RSV) (55.7%)였으며, influenza A (Flu A) (23.0%) 순이었다. 혈구 감소증은 RSV감염 환자 35.5%에서 보였고, Flu A 25.0%, 기타 바이러스 34%에서 발생하였다. 각각의 바이러스는 혈구 감소증의 빈도와 유사하게 세 가지 혈구 세포를 감소시켰다. 379명 중 83명에서 빈혈이 나타났으며($9.71{\pm}1.09g/dL$); 46명에서 호중구 감소증이 나타났다($803.70{\pm}263.09/mm^3$); 23명에서 일시적인 혈소판 감소증이 나타났다($142,434.78{\pm}86,835.18/mm^3$). 그러나 어떠한 환아도 치료가 필요한 경우는 없었다. RSV와 Flu A군 간의 임상적 특징을 비교하였을 때, 빈혈이 있는 RSV군에서 입원기간이 더 길었다. 호중구 감소에서는 RSV군에서 나이가 더 어렸으며 입원 전 발열 기간이 더 짧았다. 결론: 본 연구에서 호흡기 바이러스 감염, 특히 RSV와 Flu A에서 다양하게 혈구 감소가 나타났으나 이들 합병증은 대부분 치료가 필요하지 않았으며 임상 경과에도 영향을 미치지 않았다.

Objective: Cytopenia is a common hematologic complication of viral infections. However, information regarding hematologic effects of common respiratory virus infections is scarce. This study aimed to evaluate hematologic complications and the clinical course of patients infected with common respiratory viruses. Methods: We retrospectively analyzed 496 patients with respiratory tract infections admitted to the Department of Pediatrics, Wonkwang University Hospital from November 2011 to March 2012 using multiplex real-time polymerase chain reaction to detect the presence of respiratory viruses and hematologic abnormalities. Results: Respiratory viruses were identified in 379 patients. Respiratory syncytial virus (RSV) was most frequently detected (55.7%), followed by influenza A (Flu-A, 23.0%). Further, cytopenia was observed in 35.5% of RSV-infected patients, 25.0% of Flu-A-infected patients, and 34% of patients infected by other viruses. Each virus caused a decrease in 3 blood cell component values, which corresponded with cytopenia frequency. Of the 379 infected patients, 83 had anemia ($9.71{\pm}1.09g/dL$); 46 had neutropenia ($803.70{\pm}263.09cells/mm^3$); and 23 had transient thrombocytopenia ($142,434.78{\pm}86,835.18cells/mm^3$). However, no patient required treatment. A comparison of clinical characteristics between RSV- and Flu-A-positive patients with anemia revealed that RSV-infected patients had significantly longer duration of hospitalization. RSV was detected more commonly in young neutropenic patients, who had a shorter duration of fever. Conclusions: Our findings suggest that infections, particularly RSV and Flu-A, result in varying degrees of cytopenia, which usually improves without treatment and does not affect the clinical course of the infection.

키워드

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