• Korean Journal of Veterinary Research
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• v.55 no.4
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• pp.263-266
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• 2015

A 13-year-old, spayed, female Chihuahua dog was referred for evaluation of fever, lethargy, and dyspnea. Hematologic evaluation revealed severe neutropenia, thrombocytopenia, and mild anemia. The dog had been undergoing phenobarbital therapy for the past 7 weeks because of generalized seizures due to meningoencephalomyelitis of unknown etiology. After ruling out other possible causes of cytopenias, a tentative diagnosis was made of drug-induced blood cell dyscrasia. The neutropenia and thrombocytopenia resolved after discontinuation of phenobarbital (8 days and 15 days after discontinuation, respectively). This is the first case report in Korea to demonstrate blood dyscrasia associated with idiosyncratic adverse effects of phenobarbital.

• Journal of Chest Surgery
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• v.46 no.3
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• pp.220-222
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• 2013

Although thrombotic thrombocytopenic purpura (TTP) is a rare disease, when it develops in a post-cardiac surgery patient, it may have a fatal outcome. Since the frequency of early-onset thrombocytopenia in post-cardiac surgery patients is high, platelet concentrates are commonly transfused during postoperative management. However, when TTP is the likely diagnosis, platelet transfusion is not recommended. We experienced a postoperative TTP in a cardiac surgery patient and discovered the importance of identifying the etiology of postoperative thrombocytopenia. Here, we report the case with a brief review of the literature.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.165-168
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• 2021

We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/µL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/µL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/µL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.

• Journal of Digestive Cancer Research
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• v.4 no.1
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• pp.43-45
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• 2016

Oxaliplatin is a third-generation platinum compound widely used to treat gastrointestinal malignancy. One of the major side effects of oxaliplatin is thrombocytopenia, the development of which can limit appropriate treatment. We report a 38-year-old man with advanced gastric cancer who developed severe thrombocytopenia after FOLFOX4 (oxaliplatin, leucovorin, and fluorouracil) chemotherapy. The thrombocytopenia was associated with therapy-related myelodysplastic syndrome after cytotoxic chemotherapy and was confirmed by bone marrow biopsy and genetic study. Therefore, physicians should be aware of therapy-related hematologic complications, especially with an oxaliplatin-based chemoregimen, and might consider the bone marrow study in those patients.

• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.833-838
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• 2006

Giant platelet syndrome is a group of unique disorders characterized by the presence of abnormally large platelets, and usually accompanied by thrombocytopenia. Most cases of giant platelets are encountered in idiopathic thrombocytopenic purpura(ITP). In contrast, inherited giant platelet disorders, a group of heterogeneous diseases, are rare. Bernard-Soulier syndrome and its variants, and MYH9 related diseases have been defined at the molecular level. Abnormalities in transcription factors are implicated in a couple of macrothrombocytopenia syndromes. However, the molecular defects are unknown in gray platelet syndrome. It is important to make a proper diagnosis of congenital macrothrombocytopenia to avoid unnecessary medications and potentially dangerous treatment for presumed ITP.

• Pediatric Infection and Vaccine
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• v.23 no.1
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• pp.72-76
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• 2016

Infantile osteopetrosis is a rare congenital disorder caused by abnormal bone resorption. Patients with osteopetrosis can have severe anemia, thrombocytopenia, hepatosplenomegaly, rickets, visual impairment, and deafness. Cytomegalovirus also can cause a congenital infection with anemia, thrombocytopenia, hepatosplenomegaly, and calcifications in the brain. We report a 38-day-old infant with severe hepatosplenomegaly, thrombocytopenia, hypocalcemia, and growth failure. Real time polymerase chain reaction detected cytomegalovirus in the plasma. Skeletal radiography revealed generalized bone sclerosis. He was diagnosed with osteopetrosis along with cytomegalovirus infection. Only the test for mutation of the CLCN7 gene, representing the most common and heterogeneous form of osteopetrosis, was available, and the result was negative. With supportive care and antiviral treatment, severe thrombocytopenia due to the cytomegalovirus infection almost normalized despite the possible immunosuppression caused by osteopetrosis. We present the first report of an infant who suffered from osteopetrosis and CMV infection which was successfully treated by long term antiviral agent therapy.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.7
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• pp.565-568
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• 2017

Sjogren's syndrome is an autoimmune disease characterized by dry mouth and neutropenia. Although it does not commonly involve the central nervous system, Sjogren's syndrome sometimes affects small vessels through microangiopathic alterations. A 34-year-old woman was hospitalized for left upper quadrantanopia and a tingling sensation in the left hemibody. Brain magnetic resonance imaging revealed acute infarction in the right posterior cerebral artery territory. In laboratory tests, antinuclear (FANA2+) and anti-DNA antibodies (anti-SS-A (Ro)) were detected. Salivary gland scintigraphy revealed moderately decreasedexcretion of saliva. Based on these findings, we concluded she had Sjogren's syndrome. As in this patient, large vessel involvement in Sjogren's syndrome is far less common. Furthermore, it is difficult to administer antiplatelet drugsto patients with thrombocytopenia in Sjogren's syndrome. This is a case of the patient with Sjogren's syndrome that involved thrombocytopenia and large vessel invasion who was treated with antiplatelet drugs and hydroxychloroquine.

• Journal of Chest Surgery
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• v.51 no.3
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• pp.172-179
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• 2018

Background: This study aimed to compare preliminary data on the outcomes of sutureless aortic valve replacement (SU-AVR) with those of aortic valve replacement (AVR). Methods: We conducted a retrospective study of SU-AVR in moderate- to high-risk patients from 2013 to 2016. Matching was performed at a 1:1 ratio using the Society of Thoracic Surgeons predicted risk of mortality score with sex and age. The primary outcome was 30-day mortality. The secondary outcomes were operative outcomes and complications. Results: A total of 277 patients were studied. Ten patients (50% males; median age, 81.5 years) underwent SU-AVR. Postoperative echocardiography showed impressive outcomes in the SU-AVR group. The 30-day mortality was 10% in both groups. In our study, the patients in the SU-AVR group developed postoperative thrombocytopenia. Platelet counts decreased from $225{\times}10^3/{\mu}L$ preoperatively to 94.5, 54.5, and $50.1{\times}10^3/{\mu}L$ on postoperative days 1, 2, and 3, respectively, showing significant differences compared with the AVR group (p=0.04, p=0.16, and p=0.20, respectively). The median amount of platelet transfusion was higher in the AVR group (12.5 vs. 0 units, p=0.052). Conclusion: There was no difference in the 30-day mortality of moderate-to high-risk patients depending on whether they underwent SU-AVR or AVR. Although SU-AVR is associated with favorable cardiopulmonary bypass and cross-clamp times, it may be associated with postoperative thrombocytopenia.

• Korean Journal of Veterinary Research
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• v.47 no.4
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• pp.475-478
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• 2007

A 4-year-old spayed female, Yorkshire terrier dog with a history of petechial and ecchymotic hemorrhages on the face, trunk and hind limb was referred to Veterinary Medical Teaching Hospital, Cheju National University. The complete blood count revealed a marked thrombocytopenia ($96{\times}10^3/{\mu}l$). The biochemical profile showed only slightly increased glucose. The coagulation profile such as prothrombin time and activated partial thromboplastin time, was within the reference range. In Giemsa staining, there were no endoparasites like as Babesia spp. on the RBC. This case was diagnosed as a idiopathic thrombocytopenia in a Yorkshire terrier dog. She was treated with prednisone (1 mg/kg BW, IM q 12 h) and cephalosporin (10 mg/kg BW, IM, q 12 h). When rechecked on day 6, the platelet was within reference range ($507{\times}10^3/{\mu}l$) and also petechial and ecchymotic hemorrhages on the body were gradually improved without any complications. The dose of prednisone was decreased to 0.5 mg/kg BW, q 24 h. On day 17, we finished treatment because all the clinical signs, blood and serum chemistry were reference range and platelet count was dramatically increased.

• Korean Journal of Veterinary Service
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• v.39 no.2
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• pp.75-80
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• 2016

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease characterized by fever and thrombocytopenia. Haemaphysalis longicornis ticks comprise the major population of ticks in the environment and have been considered as the main vector for SFTS virus (SFTSV). Here we investigated the distribution of ticks carrying SFTSV collected from the environment using the dragging or sweeping methods during April~October 2015 in Jeollanam-do, Korea. Sampling was taken from Songjeong, Omi, Bangkwang, Sandong areas in Jiri walking trails. Among the total 3,869 ticks collected, 3,823 ticks (98.8%) were H. longicornis, 41 (1.1%) were Amblyomma testudinarium, and 5 (0.1%) were Ixodes nipponensis. Classification results by regional groups of H. longicornis indicated that 1,613 ticks were collected in Sandong, 1,190 ticks in Omi, 603 ticks in Bangkwang, and 417 ticks in Songjeong. In monthly distributional studies of H. longicornis based on the developmental stages, nymph (325 ticks) was collected from May to October, 94% of larvae from April to June, and 94% of adult from June to August. These results showed the different dominant stage of ticks according to seasons. However, no SFTSV-specific gene was detected in 3,823 ticks of H. longicornis, 41 of A. testudinarium and 5 of I. nipponensis.