• Title/Summary/Keyword: Anemia of acute infection

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Reticulocyte hemoglobin content for the diagnosis of iron deficiency in young children with acute infection (급성 감염성 질환을 가진 영유아에서 철결핍 진단 지표로서의 망상적혈구혈색소량)

  • Kim, Jon Soo;Choi, Jun Seok;Choi, Doo Young;You, Chur Woo
    • Clinical and Experimental Pediatrics
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    • v.51 no.8
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    • pp.827-833
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    • 2008
  • Purpose : Early identification of iron deficiency in young children is essential to prevent damaging long-term consequences. It is often difficult for the pediatrician to know which indices should be used when diagnosing these conditions especially in hospitalized young children. This study investigated the clinical significances of reticulocyte hemoglobin content in young children with acute infection. Methods : We studied 69 young children aged from 6 to 24 months admitted with acute infection in a single center. Venous blood was drawn to determine hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), hemoglobin content (CH), reticulocyte hemoglobin content (CHr), and red blood cell distribution width (RDW) using ADVIA 120 (Bayer Diagnostics, NY, USA). For evaluating iron status, iron, total iron binding capacity, ferritin and transferrin saturation (Tfsat) were determined. Iron deficiency was defined as Tfsat less than 20%, and iron deficiency anemia as Tfsat less than 20% and Hb level less than 11 g/dL. Results : In all, 47 were iron deficient; 17 of these had iron deficiency anemia. CHr was the only significant predictor of iron deficiency (likelihood ratio test=71.25; odds ratio=0.67; P<0.05). Plasma ferritin level had no predictive value (P=0.519). Subjects with CHr less than 27.4 pg had lower Hb level, MCH, CH, Tfsat, and iron levels than those with CHr 27.4 pg or more (P<0.05 for all). Conclusion : CHr level was a sensitive screening tool and the strongest predictor of iron deficiency in hospitalized infants with acute infection; it was cost saving and avoiding additional sampling. However its reference range should be established.

A Case of Hemolytic Uremic Syndrome in a Child with Ischemic Colitis (허혈성 대장염에 동반된 용혈성 요독 증후군 1례)

  • Kim Yang-Hyun;Ahn Sun-Young;Park Ji-Min;Lee Jae-Seung
    • Childhood Kidney Diseases
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    • v.8 no.1
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    • pp.86-90
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    • 2004
  • Hemolytic uremic syndrome(HUS) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia and the most common pathogen is Escherichia coli (E. coli) O157 : H7. Ischemic colitis, which rarely occurs in children, is due to the reduced local blood flow to the intestine, tissue necrosis and secondary bacterial infection. We describe a patient who was admitted with abdominal pain, vomiting and hematochezia, and diagnosed as ischemic colitis by barium enema. This patient showed hemolytic anemia, thrombocytopenia and progressive renal failure and was subsequently diagnosed as hemolytic uremic syndrome. After hemodialysis, the patient showed improvement of symptoms and resolution of renal failure and ischemic colitis.

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Hemolytic Uremic Syndrome Associated with Amoebic Dysentery (아메바성 장염과 관련된 용혈성 요독 증후군)

  • Song Chang-Ju;Lee Jin-Seok;Park Jeong-Hyun;Ha Tae-Sun
    • Childhood Kidney Diseases
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    • v.7 no.1
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    • pp.82-85
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    • 2003
  • The hemolytic uremic syndrome(HUS), a heterogenous group of disorders characterized by micorangiopathic hemolytic anemia, thrombocytopenia, and azotemia, is the most frequent cause of acute renal failure in children. The association of the HUS with E. coli O157 : H7 has been well-described, but the other intestinal infection have been relatively less reported to date. We report a 18-month-old boy presenting with typical clinical characteristics of HUS associated with amoebic dysentery with a brief review of literatures.

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Studies on the Canine Babesiasis which Occurred in Korea III. Clinical Observation on the Naturally Infected Dogs (한국(韓國)에서 발생(發生)한 Canine Babesiasis 에 관(關)한 연구(硏究) 제삼보(第三報) 자연발생환견(自然發生患犬)의 임상관찰(臨床觀察) 및 환견발생지역(患犬發生地域) 사육견(私肉犬)에 대(對)한 조사(調査))

  • Son, Jae-Young
    • Korean Journal of Veterinary Research
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    • v.4 no.1
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    • pp.7-14
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    • 1964
  • Seven cases of canine babesiasis were observed by clinically, hematologically and immunologically in the Kyungbook and Pusan area from May 1961 to October 1963. And a survey was conducted on the rising pups for their babesia, infection in the broken out districts of the disease. The results obtained were as follows: 1. Severe cases of canine babesiasis due to the same agent have been encountered in various breed, of dogs in widely separated location in the Kyungpook and Pusan area. 2. The principal symptoms oserved in infected dogs were severe anemia, weakness, inappetence, moderate fever or subnormal body temperature, increased respiration and pulse, palpitation, icterus, hemogrobinuria and redish yellow defecation. 3. Of hematological findings, decrease in erythrocytes count, hemoglobin content was evident and severe anemic changes occured which were associated with macrocytic anisocytosis. The differential leucocytes counts showed a tendency to increased monocytes and decreased monocytes and decreased basophil. 4. The principal anatomic chabges observed in two cases of infected dogs were severe anemic and icteric changes, markedly enlarged spleen, and enlarged liver with distended gall bladder. 5. Haemaphysalis bispinosa was suspected as being the principal vector of the infection. 6. It was suspected that chronic canine babesiasis would prevailed widely in Kyungpook and Pusan area, and that dogs are raised in such infected environment usually suffer only from the mild, chronic form, which may be practically symptomless, while imported dogs usually suffer from the acute form of the disease.

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Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants

  • Jeon, Ga Won
    • Clinical and Experimental Pediatrics
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    • v.65 no.4
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    • pp.182-187
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    • 2022
  • We frequently encounter newborn infants with thrombocytosis in the neonatal intensive care unit. However, neonatal thrombocytosis is not yet fully understood. Thrombocytosis is more frequently identified in newborns and young infants, notably more often in those younger than 2 years than in older children or adults. The production of megakaryocytes (megakaryopoiesis) and platelets (thrombopoiesis) is mainly regulated by thrombopoietin (TPO). Increased TPO levels during infection or inflammation can stimulate megakaryopoiesis, resulting in thrombopoiesis. TPO concentrations are higher in newborn infants than in adults. Levels increase after birth, peak on the second day after birth, and start decreasing at 1 month of age. Initial platelet counts at birth increase with gestational age. Thus, preterm infants have lower initial platelet counts at birth than late-preterm or term infants. Postnatal thrombocytosis is more frequently observed in preterm infants than in term infants. A high TPO concentration and low TPO receptor expression on platelets leading to elevated plasma-free TPO, increased sensitivity of megakaryocyte precursor cells to TPO, a decreased red blood cell count, and immaturity of platelet regulation are speculated to induce thrombocytosis in preterm infants. Thrombocytosis in newborn infants is considered a reactive process (secondary thrombocytosis) following infection, acute/chronic inflammation, or anemia. Thrombocytosis in newborn infants is benign, resolves spontaneously, and, unlike in adults, is rarely associated with hemorrhagic and thromboembolic complications.

Macrophage Activation Syndrome Triggered by Herpes Viral Infection as the Presenting Manifestation of Juvenile Systemic Lupus Erythematosus (헤르페스 바이러스 감염으로 발생한 대식 세포 활성 증후군을 첫 증상으로 한 소아 전신 홍반 루푸스)

  • Noh, Ji Hye;Jeong, Do Young;Jeon, In Su;Kim, Hwang Min
    • Pediatric Infection and Vaccine
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    • v.22 no.3
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    • pp.210-215
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    • 2015
  • Macrophage activation syndrome (MAS) is a rare complication in systemic lupus erythematosus (SLE) that can be triggered by infections. Due to the fact that MAS may mimic clinical features of underlying rheumatic disease, or be confused with an infectious complication, its detection can prove challenging. This is particularly true when there is an unknown/undiagnosed disease; and could turn into an even greater challenge if MAS and SLE are combined with a viral infection. A-14-year-old female came to the hospital with an ongoing fever for 2 weeks and a painful facial skin rash. Hepatomegaly, pancytopenia, increased aspartate aminotransferase, elevated serum ferritin and lactate dehydrogenase were reported. No hemophagocytic infiltration of bone marrow was reported. The patient was suspected for hemophagocytic lymphohistiocytosis. Her skin rashes were eczema herpeticum, which is usually associated with immune compromised conditions. With the history of oral ulcers and malar rash, positive ANA and low C3, C4 and the evidence of hemolytic anemia, she was diagnosed as SLE. According to the diagnostic guideline for MAS in SLE, she was diagnosed MAS as well, activated by acute HSV infection. After administering steroids and antiviral agent, the fever and skin rash disappeared, and the abnormal laboratory findings normalized. Therefore, we are reporting a rare case of MAS triggered by acute HSV infection as the first manifestation of SLE.

Indication of Bone Marrow Aspiration in Acute Idiopathic Thrombocytopenic Purpura in Children (소아 급성 특발성 혈소판 감소성 자반증에서 골수흡인 검사의 적응)

  • Kim, Won-Duck;Hah, Jeong-Ok
    • Journal of Yeungnam Medical Science
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    • v.18 no.2
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    • pp.239-245
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    • 2001
  • Background: Acute idiopathic thrombocytopenic purpura(ITF) is one of the common hematologic disorders in children. Bone marrow aspiration (BMA) is often performed in children with acute ITP to rule out leukemia, aplastic anemia or other hematologic diseases. However, whether BMA is needed in children with typical clinical and hematological features of acute ITP have been questioned. This study was performed to examine the proper indication of BMA in acute childhood ITF. Materials and Methods: The medical records and BMA reports of children with the provisional diagnosis of acute ITP were reviewed from January 1984 to December 2000. Patients were divided into two groups, one with typical and another with atypical clinical and hematological features of acute ITP. Typical acute ITP group was characterized by the history of previous viral infection, well being appearance, no hepatosplenomegaly, no lymphadenopathy, normal Hb, WEC, neutrophil count and peripheral blood smear except thrombocytopenia. A platelet count of $50{\times}l0^9/L$ or lower was the cutoff level. Results: Total 120 children with the provisional diagnosis of acute ITP were included. One hundred eighteen of them were confirmed to have acute ITP by BMAs. Of these, 66 had typical and 54 had atypical features. All of typical features and 52 of 54 with atypical features of acute ITP were confirmed to have acute ITP by BMAs. Two patients with atypical features of acute ITP were diagnosed as aplastic anemia and myelodyspalstic syndrome, respectively, by BMAs. Conclusion: This study concludes that BMA is not needed for the children with typical features of acute ITP but it is needed for the children with atypical features of acute ITP to rule out other hematologic disorders.

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Molecular Characterization of Gastrothylax crumenifer (Platyhelminthes: Gastrothylacidae) from Goats in the Western Part of India by LSU of Nuclear Ribosomal DNA

  • Kumar, Ashwani;Chaudhary, Anshu;Verma, Chandni;Singh, Hridaya Shanker
    • Parasites, Hosts and Diseases
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    • v.52 no.6
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    • pp.701-705
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    • 2014
  • The rumen parasite, Gastrothylax crumenifer (Platyhelminthes: Gastrothylacidae), is a highly pathogenic trematode parasite of goat (Capra hircus). It sucks blood that causes acute disease like anemia, and severe economic losses occur due to morbidity and mortality of the ruminant infected by these worms. The study of these rumen paramphistomes, their infection, and public health importance remains unclear in India especially in the western part of state Uttar Pradesh (U.P.), Meerut, India, where the goat meat consumption is very high. This paper provides the molecular characterization of G. crumenifer recovered from the rumen of Capra hircus from Meerut, U.P., India by the partial sequence of 28S rDNA. Nucleotide sequence similarity searching on BLAST of 28S rDNA from parasites showed the highest identity with those of G. crumenifer from the same host Capra hircus. This is the first report of molecular identification of G. crumenifer from this part of India.

Physical Activity and Exercise Intervention for Cancer Survivors (암 환자의 신체활동 및 운동)

  • Chae, Jean;Park, Hyeong-Jun;Lee, Ji-Yeong;Jung, Hyun-Sik;Lee, Sang-Hun
    • Journal of Korean Traditional Oncology
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    • v.17 no.1
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    • pp.27-38
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    • 2012
  • Objective : To present an overview of current reports and guidelines of physical activity and exercise intervention for cancer survivors Methods : We searched Pubmed for the related studies such as randomized controlled trials and observational studies, as well as published guidelines or recommendations for exercise intervention. Results : Physical activity and exercise intervention is considered safe and effective for most cancer survivors. According to the guidelines, patients with peripheral neuropathy, musculoskeletal disorder, or those who are at risk of fracture, should undergo proper medical assessment before starting exercise intervention. Also, patients with bone metastasis, thrombocytopenia, symptomatic anemia, or acute infection may fall into one of the contraindications of exercise intervention. Conclusions : Physical activity and exercise intervention may play a major role in improving physical functioning, quality of life, or treatment-related symptoms of cancer survivors. It is necessary to recognize the benefits and precautions of exercise in caring cancer patients.

Atypical Hemolytic Uremic Syndrome in a 13-year-old Lao Girl: A Case Report

  • Kedsatha, Philavanh;Cheong, Hae Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.23 no.1
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    • pp.43-47
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    • 2019
  • Atypical hemolytic uremic syndrome (aHUS), a rare form of thrombotic microangiopathy, is distinguished from the typical form by the absence of a preceding verotoxin-producing Escherichia coli infection. Notably, aHUS occurs in association with genetic or acquired disorders causing dysregulation of the alternative complement pathway. Patients with aHUS may show the presence of anti-complement factor H (CFH) autoantibodies. This acquired form of aHUS (antiCFH-aHUS) primarily affects children aged 9-13 years. We report a case of a 13-year-old Lao girl with clinical features of aHUS (most likely anti-CFH-aHUS). The initial presentation of the patient met the classical clinical triad of thrombotic microangiopathy (microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury) without preceding diarrheal illness. Low serum levels of complement 3 and normal levels of complement 4 indicated abnormal activation of the alternative complement pathway. Plasma infusion and high-dose corticosteroid therapy resulted in improvement of the renal function and hematological profile, although the patient subsequently died of infectious complications. This is the first case report that describes aHUS (possibly anti-CFH-aHUS) in Laos.