• Title/Summary/Keyword: 혈소판 감소증

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Pulmonary Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension in a Patient with Antiphospholipid Syndrome and Systemic Lupus Erythematosus (항인지질 증후군과 전신성 홍반성 루푸스 환자에게 발생된 만성 폐혈전색전성 폐동맥 고혈압에 대해 시행한 혈전내막제거술)

  • Kang, Pil-Je;Kim, Jeong-Won;Lee, Jae-Won
    • Journal of Chest Surgery
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    • v.40 no.12
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    • pp.867-870
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    • 2007
  • Antiphospholipid syndrome (APS) is defined as venous and/or arterial thromboses, recurrent fetal losses, thrombocytopenia in combination with repeatedly positive tests for the lupus anticoagulant (LAC), and anticardiolipin antibodies (aCL). The pulmonary manifestation is APS are relatively rare. We report a rare case of antiphopholipid syndrome with systemic lupus erythematosus in a patient who presented with pulmonary hypertension secondary to a chronic pulmonary thromboembolism. A bilateral thromboendarterectomy was performed satisfactorily and the incision was extended to the left intrapleural pulmonary artery.

Monosomy 21 Mosaicism in a Child with Dyserythropoiesis (적혈구 이형성증(Dyserythropoiesis)의 소견을 보이는 부분 21-monosomy 증후군)

  • Lim, Jae-Young;Seo, Ji-Hyoun;Choi, Myoung-Bum;Park, Chan-Hoo;Woo, Hyang-Ok;Youn, Hee-Shang
    • Clinical and Experimental Pediatrics
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    • v.46 no.4
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    • pp.397-399
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    • 2003
  • All complete monosomy 21 appear to be lethal early in their development in humans and only survive in mosaic forms. Complete monosomy 21 is a very rare and usually debilitating genetic disorder. Partial monosomy 21 is also rare and is thought to constitute a clinical syndrome consisting of peculiar faces, hypertonia, psychomotor retardation, and slow growth. We experienced a case of monosomy 21 mosaicism. Chromosome analysis demonstrated mosaicism for cell lines in the lymphocytes examined; 45, XX, -21/46, XX. The main clinical features were craniofacial dysmorphism including high arched palate, submucosal cleft, micrognathia and arthrogryposis-like symptoms including flexion deformity of fingers. And hematological findings were revealed dyserythropoiesis, thrombocytopenia and eosinophilia. Currently, the patient has nearly compatible growth, but a mild degree of mental retardation. We report here an 8 years old female child with apparent monosomy 21 mosaicism associated with dyserythropoiesis, thrombocytopenia and eosinophilia, with a review of the associated literatures.

A Case of Mycoplasma haemofelis Infection in a Korean Domestic Shorthair Cat (한국 토종 단모종 고양이에서 Mycoplasma Haemofelis 감염 증례)

  • Kim, Mi-Ryung;Lee, Seung-Jin;Lee, Keun-Woo
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.57-60
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    • 2014
  • A six-months-old male Korean domestic shorthair cat was presented with fever, tachypnea, anorexia, and weight loss and admitted to Lee Seung Jin Animal Medical Center. During the routine physical examination, clinical signs such as mild dehydration and jaundice in the sclera were present. The complete blood count (CBC) and serum chemistry result showed anemia, thrombocytopenia, neutrophilia, and hyperbilirubinemia. Radiography revealed hepatomegaly and splenomegaly. Blood smear and microscopic examination showed severe hemolysis and anisocytosis. We sent the blood sample to the Neodin Veterinary Laboratory for PCR analysis to conduct a test to find out Ehlichia, feline hemoplasmas (haemobartonella), feline leukemia virus (FeLV), feline immunodeficiency virus (FIV) and anaplasma infection. According to PCR examination, the blood of this cat was positive for feline hemoplasmas (Mycoplasma haemofelis), but negative for other pathogens. The patient was prescribed doxycycline for 4 weeks and prednisolone for 1 week. The free of feline hemoplasmas infection was confirmed by PCR recheck after six months.

Clinical Features of Indigenous Vivax Malaria in Children (소아에 발생한 삼일열 말라리아의 임상적 특성)

  • Lee, Eun Jin;Lee, Chong Guk;Cho, Chong Rae
    • Pediatric Infection and Vaccine
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    • v.10 no.2
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    • pp.200-207
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    • 2003
  • Purpose : Malaria is known to have been eradicated for a few decades through persistent national health program in South Korea. However, malaria caused by Plasmodium vivax has started to reappear incidiously among military personnel near to DMZ since 1993. After then, the number of malarial cases have been increased abruptly year by year. We analyzed the children of indigenous malaria who were diagnosed by peripheral blood smear and malarial antibody test with regards to epidemiologic and clinical manifestations. Methods : The study 13 cases below 15 years of age, who were confirmed as vivax malaria during from January 2000 to August 2003. We retrospectively analyzed epidemiologic data, clinical manifestations, laboratory findings and therapeutic responses. Results : All of 13 cases were indigenous and tested positive for Plasmodium vivax. Of 13 patients, 9 were male and 4 were female. Mean age of onset was $9.5{\pm}3.6$ years old. Ilsan(n=9) was the most prevalent area, the most patients(n=11) were presented in summer (from June to August). A characteristic feature of periodic 3 day fever in patients with P.vivax infection was reported in only 2 among 13 cases. Thrombocytopenia was most prominent findings, which was accompanied by 12 of 13 patients and pancytopenia was appeared in 3 patients on this study. The therapeutic responses of hydroxycholoquine were very good in all cases, and abnormal laboratory findings were recovered and no relapse during follow-up period. Conclusion : Vivax malaria is indigenous in Korea near to DMZ, but recently endemic area seemed to be extended southward. Plasmodium vivax is the cause of indigenous malaria of children. As for children with high fever accompanying thrombocytopenia in endemic area of Korea, malaria must be included in differential diagnosis whether the type of fewer is periodic 3 day fever or not. Malaria antibody test is helpful as a screening test for malaria.

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Prevalence and clinical significance of the positive antinuclear antibody in children with idiopathic thrombocytopenic purpura (소아 특발혈소판감소 자색반병 환자에서 항핵항체 검사의 양성률 및 임상적 의의)

  • Jun, So Eun;Park, Seong Sik;Lim, Young Tak
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1217-1221
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    • 2008
  • Purpose : An association between idiopathic thrombocytopenic purpura (ITP) and systemic lupus erythematosus (SLE) has been recognized for decades because thrombocytopenia is the first manifestation in some patients with SLE. However, the risk of later development of SLE in childhood ITP is currently unknown. We retrospectively evaluated the incidence and clinical significance of the positive antinuclear antibody (ANA) in children with acute ITP. Methods : This study was retrospectively performed to review the clinical and laboratory characteristics in 77 children diagnosed to have acute ITP and admitted to the Pusan National University Hospital between January 2003 and December 2006. Patients tested positive for ANA were regularly followed-up for at least 12 months for symptoms indicative of SLE. Results : Seventy-seven children were included in the study; 38 males (49.4%) and 39 females (50.5%), the mean age was 4.5 years. Sixteen (20.8%) ITP patients had a positive ANA, with a median titer of 1:320. The mean age of the patients with positive ANA was 9.3 years, which is much older than 3.3 years for patients with negative ANA (P<0.05). The positive ANA group was predominantly female (81.3%) compared to the negative ANA group (P<0.05). There was no statistically significant difference in mean platelet counts between both groups. No statistically significant difference was found in ANA positivity and progression to chronic ITP or SLE. After the median follow-up of 32 months, SLE was diagnosed only in one ITP patient with positive ANA. Conclusion : Our data demonstrated that ANA positivity is often found in children with acute ITP. Large-scale studies should be considered to determine the significance of ANA positivity in childhood ITP for the later development of SLE.

Portal Vein Thrombosis in a Dog with Dirofilariasis (심장사상충에 감염된 개에서 발생한 문정맥혈전증)

  • Yun, Seok-Ju;Cheon, Haeng-Bok;Han, Jae-Ik;Kang, Ji-Houn;Chang, Jin-Hwa;Na, Ki-Jeong;Chang, Dong-Woo
    • Journal of Veterinary Clinics
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    • v.27 no.5
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    • pp.600-604
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    • 2010
  • A ten-year-old female mongrel dog was presented to Veterinary Medical Center, Chungbuk National University with the signs of anorexia, weakness, and hemoglobinuria. Patient had been diagnosed as dirofilariasis based on heartworm antigen test and treated with adulticide (melarsomine) at local hospital one day before admission. On laboratory examinations, there were hypochromic and microcytic regenerative anemia, thrombocytopenia, moderate neutrophilia, and increase ALT, AST, and ALP. Radiographic exam showed main pulmonary artery bulging, pulmonary infiltration and hypervascularity, reduced abdominal serosal detail and mild hepatomegaly. Abdominal ultrasonographic exam showed mild peritoneal effusion and large hyperechoic thrombi at trifurcation of the porta hepatica and the splenic vein. In addition, intraluminal low density area and intravascular filling defect were confirmed on contrast enhanced CT scanning at the same anatomic locations. Patient was treated with anticoagulant and thrombolytic therapy. On day 42 after treatment, complete resolution of thrombi was confirmed via ultrasonography and improvement of clinical signs was observed.

Clarithromycin Therapy for Scrub Typus (쯔쯔가무시(Tsutusgamushi)병에서 Clarithromycin의 치료 효과)

  • Kim, Soon;Jung, Eun Mi;Moon, Kyung Hyun;Yoe, Sung Yeob;Eum, Soo Jung;Lee, Joo Hyung;Jo, Sung Rae;Ma, Sang Hyuk
    • Pediatric Infection and Vaccine
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    • v.9 no.2
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    • pp.175-181
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    • 2002
  • Purpose : Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus. Methods : Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients. Results : There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications. Conclusion : Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

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A case of Plasmodium vivax malaria occurring during a school excursion to Pocheon-gun (수학여행 후 발생한 Plasmodium vivax 말라리아 1례)

  • Kwak, Byung Ok;Chung, Sochung;Kim, Kyo Sun
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.85-88
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    • 2010
  • Malaria caused by Plasmodium species is characterized by paroxysms of fever, chills, fatigue, anemia, and splenomegaly. Vivax malaria has lately re-emerged as an infectious disease and has exhibited high transmission rate in northern Gyeonggi-do province. We encountered a case of malaria in a child presenting with fever and thrombocytopenia who had recently made a school excursion to Pocheon-gun, Gyeonggi-do. The child was diagnosed with Plasmodium vivax malaria and treated with hydroxychloroquine and primaquine. Here, we present this case with a brief review of the literature.

Case Report of Thrombocytopenia Improved by Traditional Korean Medicine (한의치료로 호전을 보인 혈소판감소증 증례 1례)

  • Ye-seul Kim;Ji-yoon Park;Jung-hwa Hong;Eun-joo Seok;Young-ju Rhee;Lib Ahn;Dong-jun Choi
    • The Journal of Internal Korean Medicine
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    • v.44 no.2
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    • pp.216-221
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    • 2023
  • Objective: This study reports on the improvement of a patient with thrombocytopenia using Korean medicine. Methods: A 29-year-old woman was treated with acupuncture, moxibustion, and Korean herbal medicine. Platelet counts were checked periodically to identify improvements in thrombocytopenia. Results: The platelet count showed a marked improvement during treatment, with no side effects for the patient. Conclusion: This study suggests that Korean medicine could be used for the management of thrombocytopenia.

Totally Laparoscopic Total Gastrectomy for Early Gastric Cancer: An Initial Experience (조기위암으로 진단된 환자에서의 전복강경하 위전절제술의 초기 경험)

  • Lee, Jeong-Seon;Lee, Han-Hong;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
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    • v.10 no.1
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    • pp.26-33
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    • 2010
  • Purpose: We wanted to evaluate the technical feasibility and safety of totally laparoscopic total gastrectomy (TLTG) for treating early gastric cancer. Materials and Methods: The medical records of 11 consecutive patients who underwent TLTG after being diagnosed with early gastric cancer at Incheon St. Mary's Hospital, The Catholic University of Korea from February 2005 to September 2009 were retrospectively reviewed and their clinicopathologic characteristics and the surgical results wereinvestigated. Results: The mean operation time was $385.6{\pm}94.1$ minutes, the mean time for creating an intracorporeal anastomosis was $97.5{\pm}60.0$ minutes and the mean number of the harvested lymph nodes was $46.6{\pm}15.4$ The mean number of days after operation until starting a liquid diet was the $6.1{\pm}7.6^{th}$ postoperative day and the mean hospital stay after surgery was $14.2{\pm}11.9$ days. There was no case of open conversion, but there were 2 cases of intraoperative complication and 3 cases of postoperative complication. There was one case of postoperative mortality. The patient suffered from thrombocytopenia of an unknown cause, which was refractory to platelet transfusion, on $4^{th}$ postoperative day and the patient died of intraabdominal bleeding on the $6^{th}$ postoperative day. Conclusion: TLTG was a technically feasible and relatively safe procedure. However, a long time for creating the intracoproeal anastomosis and a long operation time are still problems to be solved.