• Title/Summary/Keyword: Pancytopenia

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Long lasting mesalazine-induced pancytopenia in a patient with ulcerative colitis

  • Ko, Juyeon;Song, Hyun Joo;Han, Sanghoon;Moon, Chiyoon
    • Journal of Medicine and Life Science
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    • v.16 no.2
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    • pp.46-51
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    • 2019
  • Inflammatory bowel disease (IBD) is an immune-mediated chronic inflammatory intestinal condition. With development of various treatment options for IBD, 5-aminosalicylic acid (5-ASA) agents became the drugs of choice due to high efficacy and low risk of complication, specifically effective at inducing and maintaining remission in ulcerative colitis(UC). Pancytopenia caused by 5-ASA agents, especially by mesalazine, has been rarely reported compared with azathioprine, which is commonly used for glucocorticoid-dependent IBD and known to have risk of bone marrow suppression. In the present report, we describe the case of a 57-year-old woman diagnosed with UC, who developed pancytopenia due to adverse effect of mesalazine after recovery from azathioprine-induced pancytopenia. After withdrawal of mesalazine, the laboratory values consistent with myelosuppression continued for 3 months while pancytopenia from azathioprine remained only for 2 weeks. Since pancytopenia can be fatal due to its risk of severe bleeding and infection, close monitoring of clinical presentation is important when starting mesalazine and laboratory data should be evaluated whenever the patients present related symptoms. Furthermore, we suggest that complete blood cell counts should be considered when resuming mesalazine following the development of pancytopenia from any cause, as routinely recommended for azathioprine use.

Pancytopenia Improves with Compromised Liver Function in A Hepatocellular Carcinoma Patient Treated by Modified Sipjeondaebo-tang (십전대보탕가감방을 투여한 간세포암종 환자에서 범혈구감소증 호전 및 간수치 상승 증례)

  • Kim, Jong-Min;Jeon, Hyung-Joon;Cho, Chong-Kwan;Lee, Yeon-Weol;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.34 no.4
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    • pp.478-483
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    • 2013
  • Objectives : To observe the therapeutic effects of an oriental herbal prescription in a hepatocellular carcinoma patient with splenomegaly and pancytopenia. Methods : Modified Sipjeondaebo-tang was prescribed three times a day to a hepatocellular carcinoma patient with splenomegaly and pancytopenia. Laboratory tests were carried out regularly to observe the therapeutic effects of the oriental herbal prescription for pancytopenia. Results : When treated with modified Sipjeondaebo-tang including Cinnamomi Cortex, the levels of white blood cells, red blood cells, hemoglobin, and hematocrit increased. However, aspartate transaminase, alanine transaminase, alkaline phosphatase, gamma-glutamic transpeptidase, total bilirubin, direct bilirubin levels also increased. Conclusions : Administering modified Sipjeondaebo-tang with Cinnamomi Cortex showed effect in improving pancytopenia but an increase in liver enzyme levels was also observed.

A Case of Pancytopenia with Hyperthyroidism

  • Kim, Tae Hoon;Yoon, Ji Sung;Park, Byung Sam;Lee, Dong Won;Cho, Jae Ho;Moon, Jun Sung;Kim, Eui Hyun;Won, Kyu Chang;Lee, Hyoung Woo
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.47-50
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    • 2013
  • There has been an increase in the number of reports of atypical manifestations of Graves' disease (GD), such as jaundice, anemia, thrombocytopenia and leukopenia. Pancytopenia also rarely occurs in GD. In this paper, a case of pancytopenia with GD that was successfully treated with an anti-thyroid drug is reported. In this case, a 69-year-old woman showed pancytopenia with a normal peripheral blood smear, bone marrow aspiration smear and bone marrow biopsy. Her thyroid function test and thyroid scintigraphy confirmed her hyperthyroid status. Her laboratory abnormality and clinical condition improved after she was treated with an anti-thyroid drug. This is a rare case of pancytopenia associated with GD.

Evaluation of hematologic profile may be needed for patients treated with oxcarbazepine

  • Jung, Gu Hyun;You, Su Jeong
    • Clinical and Experimental Pediatrics
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    • v.62 no.8
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    • pp.312-316
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    • 2019
  • Purpose: The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC. Methods: The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of Pediatrics of Inje University Sanggye Paik Hospital from July 2001 to July 2018, were retrospectively reviewed. Results: Of the 184 patients, 10 (5.4%) developed leukopenia in addition to pancytopenia and 2 (1.0%) developed pancytopenia. Leukopenia developed in 11 days to 14 years after OXC administration and was more frequent in males than in females (male vs. female, 9 vs. 1; Fisher exact test, P<0.05). Of the eight patients with leukopenia alone, 7 continued OXC treatment; 6 improved without intervention; 1 was lost to follow-up; and 1 received a reduced OXC dose, who improved after intervention. Pancytopenia developed within 2 months of initiation of OXC treatment. Both patients initially continued OXC. One improved within 1 month and continued treatment with OXC, but the other showed progression of the side effect, leading to the discontinuation of OXC and subsequent improvement within 1 month. There were no significant differences in the ages of the patients, OXC dose, and duration of OXC treatment between patients with and without these side effects of OXC (P>0.05, t-test). Conclusion: OXC-induced leukopenia is not rare and may result in pancytopenia. Patients being treated with OXC should be regularly monitored for abnormal complete blood count profiles.

A Case Report of Dyspepsia in a Patient with Liver Cirrhosis and Pancytopenia (범혈구감소증을 동반한 간경변 환자의 소화불량 증례 보고)

  • Kim, Eun-seo;Bae, In-suk;Shin, Gil-cho
    • The Journal of Internal Korean Medicine
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    • v.38 no.5
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    • pp.592-599
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    • 2017
  • Objectives: The purpose of this study was to report the improvement of dyspepsia in a patient with liver cirrhosis and pancytopenia following traditional Korean medical treatment. Methods: A patient who suffered from dyspepsia with liver cirrhosis and pancytopenia was treated with herbal medicine, acupuncture, cupping, and moxibustion. The effect of treatment was measured with a visual analogue scale (VAS). Results: After treatment, the symptoms of dyspepsia improved and VAS score decreased. Conclusions: Traditional Korean medicine (TKM) could be effective for treatment of dyspepsia in patients with liver cirrhosis.

Two Cases of Severe Pancytopenia Associated with Low-Dose Methotrexate Therapy in Patients with Chronic Kidney Disease and Rheumatoid Arthritis (류마티스 관절염을 가진 만성신질환 환자에서 저용량 methotrexate 투여 후 발생한 중증 범혈구 감소증 2예)

  • Kim, Hong-Ik;Lee, Woo-Hyun;Oh, Jang-Seok;Hong, Hyo-Rim;Lee, In-Hee
    • Journal of Yeungnam Medical Science
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    • v.28 no.1
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    • pp.60-69
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    • 2011
  • Due to its efficacy and tolerability, low dose oral methotrexate (MTX) therapy has been widely used for treatment of rheumatoid arthritis (RA). However, it can rarely cause serious, life-threatening hematologic toxicities, such as pancytopenia. We report here on two patients with chronic kidney disease (CKD), who developed severe pancytopenia after 5 years (cumulative dose 1,240 mg) and 4 years (cumulative dose 1,320 mg) of low dose MTX therapy for treatment of RA, respectively. Both patients presented with renal insufficiency, hypoalbuminemia, concurrent use of nonsteroidal anti-inflammatory drugs, and elevated mean corpuscular volume of red blood cells (RECs), all of which are known as risk factors of MTX-induced pancytopenia. Despite receiving treatment, which included REC and platelet transfusions, antibiotic therapy, granulocyte colony stimulating factor, and leucovorin rescue, one patient died of sepsis. Based on our case study, prompt investigation of risk factors associated with MTX toxicity is required for all patients receiving MTX therapy. MTX treatment, even at a low dose, should be discontinued in patients with advanced CKD.

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Korean Medical Treatment of Sequela Following Chemotherapy for Recurrent Ovarian Cancer after Hysterectomy: a Case Report (재발성 난소암 환자의 화학적 항암요법 후유증 치험 1례)

  • Baek, Ji-Won;Nam, Woo-Jin;Kim, Su-Na;Kong, Won-Ho;Park, Yeo-Bin;Park, Yun-Leong;Gong, Bok-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.129-137
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    • 2019
  • Objectives: Most of the time after chemotherapy for ovarian cancer, the immune system is getting even worse with reduction of whole blood cell. The purpose of this study is to report the effect of korean medical treatment on Sequela including pancytopenia after chemotherapy for recurrent ovarian cancer after hysterectomy. Methods: The patient having treated with hospital management from June 8th in 2017 until July 5th in 2017, participated. Her chief complaints were fatigue, tinnitus, dizziness, decreased appetite due to glossodynia and constipation. We diagnosed her as pancytopenia based on her whole blood test result. We treated the patient with acupuncture, herbal medicine, cupping and moxibustion. The efficacy of treatment was evaluated with Numerical Rating Scale (NRS) and blood test. Results: During hospitalization period, the symptoms including fatigue, tinnitus, dizziness, decreased appetite, constipation and pancytopenia were reduced. After discharging, we identified that her blood levels are maintained and ovarian cancer no longer recurred. Conclusions: To recover from Sequela including pancytopenia following chemotherapy for recurrent ovarian cancer after hysterectomy, Korean medical treatment is considered to be effective.

A Case Of Myelodysplastic Syndrome (골수이형성증후군(骨髓異形成症候群) 환자(患者) 일례(一例)에 대한 증례(症例) 보고(報告))

  • Kim, Jong-Dae
    • The Journal of Internal Korean Medicine
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    • v.20 no.1
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    • pp.274-279
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    • 1999
  • In order to look about the effect and possibility of oriental medical diagnosis and treatment of pancytopenia of myelodysplastic syndrome. For a patient who has pancytopenia. we diagnose him as myelodysplastic syndrome by CBC, LFT, Ultrasonic wave, Vitamin B12 test, Bone marrow test, Folic acid test and doing Herb-medication, Moxa-Tx continually, we observed the change of WBC, RBC. HGB. MCV, Platelet. ESR with following up CBC test ten times Finally, WBC increased by 900, RBC increased by 400000, MCV was reduced by 7fl. HGB increased by 1.3g/dl. Hct increased by 3.2%, ESR was reduced from 127 to 35mm/h. We diagnosed myelodysplastic syndrome as 'CONSUMPTIVE DISEASE' in oreintal medicine. The treatment effect of pancytopenia was achieved by Herb-medication and Moxa-Tx for invigorating qi, enriching the blood, invigorating the spleen and the kidney-yang, Now we need the study of oriental medical treatment for Aplastic Anemia and AML which is similar this.

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A Case of Sarcoidosis with Pancytopenia as Resulting from Bone Marrow Involvement (골수를 침윤하여 범혈구감소증을 나타낸 유육종증 1예)

  • Park, Tai Sun;Kim, Dae-Young;Park, Seo-Jin;Kim, Yi Rang;Na, Soo Young;Park, Jin Wook;Oh, Dong Wook;Choi, Jun Seok;Jo, Jung Min;Chang, Youjin;Kim, Won Young;Choi, Chang-Min
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.6
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    • pp.560-564
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    • 2009
  • Sarcoidosis is a granulomatous disease that can involve any organ, although it primarily involves the lungs, intrathoracic lymph nodes, skin, and eyes. We present a case of sarcoidosis with pancytopenia, resulting from bone marrow involvement. A 35-year-old man was admitted to hospital for chronic cough and blurred vision. On chest computed tomography, there were multiple pulmonary nodules and mediastinal lymph nodes enlargement. As the patient also showed pancytopenia, we performed a bone marrow biopsy, as well as a transbronchial lung biopsy. Both biopsies showed non-caseating granulomas. We diagnosed the patient with sarcoidosis with pulmonary, bone marrow, uvea, liver and spleen involvement. After oral steroid therapy, the patient's symptoms as well as his pancytopenia improved. We present this case to demonstrate the significance of bone marrow biopsy in cases of sarcoidosis with pancytopenia, as well the possibility of clinical improvement with steroid treatment.