DOI QR코드

DOI QR Code

A 22-month-old Boy with Acute Glomerulonephritis Coexistent with Hemolytic Anemia and Idiopathic Thrombocytopenia

  • Park, Hye Won (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Seo, Bo Seon (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Jung, Su Jin (Department of Pediatrics, CHA Bundang Medical Center, CHA University) ;
  • Lee, Jun Ho (Department of Pediatrics, CHA Bundang Medical Center, CHA University)
  • 투고 : 2015.02.17
  • 심사 : 2015.04.13
  • 발행 : 2015.04.30

초록

Hemolytic anemia and thrombocytopenia are rare clinical manifestations of acute glomerulonephritis. Initially, in all such cases, a diagnosis of hemolytic uremic syndrome, thrombotic thrombocytopenic purpura, systemic lupus erythematosus, and amyloidosis should be ruled out. The presence of hemolytic anemia and thrombocytopenia is rare, but possible, in a case of acute poststreptococcal glomerulonephritis, and may result in delayed diagnosis or misdiagnosis. Correct and timely diagnosis would ensure adequate treatment in such patients. We report of a 22-month-old boy with acute glomerulonephritis coexistent with hemolytic anemia and idiopathic thrombocytopenia.

키워드

참고문헌

  1. Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Curr Opin Pediatr 2008;20:157-62. https://doi.org/10.1097/MOP.0b013e3282f45bcf
  2. Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Current opinion in pediatrics 2008;20:157-62. https://doi.org/10.1097/MOP.0b013e3282f45bcf
  3. Michel M, Chanet V, Dechartres A, Morin AS, Piette JC, Cirasino L, et al. The spectrum of Evans syndrome in adults : new insight into the disease based on the analysis of 68 cases Blood 2009;114:3167-72.
  4. Savasan S, Warrier I, Buck S, Kaplan J, Ravindranath Y. Increased lymphocyte Fas expression and high incidence of common variable immunodeficiency disorder in childhood Evans' syndrome. Clin Immunol 2007;125:224-9. https://doi.org/10.1016/j.clim.2007.08.010
  5. Sachs UJ, Roder L, Santoso S, Bein G. Does a negative direct antiglobulin test exclude warm autoimmune haemolytic anaemia? A prospective study of 504 cases. Br J Haematol 2006;32:655-6.
  6. Liesveld JL, Rowe JM, Lichtman MA. Variability of the erythropoietic response in autoimmune hemolytic anemia: analysis of 109 cases. Blood 1987;69:820-6. https://doi.org/10.1182/blood.V69.3.820.820
  7. Ahn SY, Ingulli E. Acute poststreptococcal glomerulonephritis: an update. Curr Opin Pediatr 2008;20:157-62. https://doi.org/10.1097/MOP.0b013e3282f45bcf
  8. Oda T, Yoshizawa N, Yamakami K, Tamura K, Kuroki A, Sugisaki T, et al. Localization of mephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis. Hum Pathol 2010;41:1276-85. https://doi.org/10.1016/j.humpath.2010.02.006
  9. Yamakami K, Yoshizawa N, Wakabayashi K, Takeuchi A, Tadakuma T, Boyle MD. The potential role for nephritis-associated plasmin receptor in acute poststreptococcal glomerulonephritis. Methods 2000;21:185-97. https://doi.org/10.1006/meth.2000.0990
  10. Eison TM, Ault BH, Jones DP, Chesney RW, Wyatt RJ. Post-streptococcal acute glomerulonephritis in children: clinical features and pathogenesis. Peidatr Nephrol 2011;26:165-80. https://doi.org/10.1007/s00467-010-1554-6
  11. Watanabe T. Atypical clinical manifestations of acute poststreptococcal glomerulonephritis. Sharma S. Prabhakar, editor. An update on glomerulopathies - clinical and treatment aspects. InTech, 2011;151-68.
  12. Gehrs BC, Friedberg RC. Autoimmune hemolytic anemia. Am J Hematol 2002;69:258-71. https://doi.org/10.1002/ajh.10062
  13. Rizkallah MF, Ghandour MH, Sabbah R, Akhtar M. Acute thrombocytopenic purpura and poststreptococcal acute glomerulonephritis in a child. Clin Pediatr 1984;23:581-3. https://doi.org/10.1177/000992288402301009
  14. Muguruma T, Koyama T, Kanadani T, Furujo M, Shiraga H, Ichiba Y. Acute thrombocytopenia associated with post-streptococcal acute glomerulonephritis. J Paediatr Child Health 2000;36:401-2. https://doi.org/10.1046/j.1440-1754.2000.00521.x
  15. Benudiz N. Recognizing the elusive signs and symptoms of PSGN. Jaapa 2007;20:20-5.
  16. George JN. How I treat patients with thrombotic thrombocytopenic purpura: 2010. Blood 2010;116:4060-9. https://doi.org/10.1182/blood-2010-07-271445
  17. Eknoyan G, Riggs SA. Renal involvement in patients with thrombotic thrombocytopenic purpura. Am J Nephrol 1986; 6:117-31. https://doi.org/10.1159/000167066