• Title/Summary/Keyword: Thrombocytopenia

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Distribution of ticks carrying Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) around Jiri walking trails of Jeollanam-do, Korea (지리산둘레길에서 채집한 참진드기의 분포와 참진드기에서의 중증열성혈소판감소증후군바이러스 검출)

  • Song, Byung Joon;Lim, Hyun Cheol;Ha, Tae Man;Jeon, Doo Yung;Yang, Soo In;Song, Hyeon Je
    • 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.

Prognostic Factors of Necrotizing Enterocolitis (신생아 괴사성 장염의 예후 인자에 관한 연구)

  • Kang, Dong-Won;Gwak, Geum-Hee;Yang, Keun-Ho;Bae, Byung-Noe;Kim, Ki-Hwan;Han, Se-Whan;Kim, Hong-Joo;Kim, Young-Duk;Choi, Myeung-Jae
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.144-152
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    • 2008
  • Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency in the neonatal population. The aim of this study is to evaluate surgical indication and prognostic factors of NEC. Clinical data of seventy patients, diagnosed as NEC between January 2000 & January 2007, were reviewed retrospectively. Fifty-seven patients had medical treatment and 7 of them died. Thirteen patients who presented with pneumoperitoneum on plain abdominal film or were refractory to medical treatment received surgical treatment, and 5 of them died. All the expired 12 patients weighed less than 2500 g. Twenty out of seventy patients showed thrombocytopenia, and 11 patients of them died. The finding of pneumoperitoneum and thrombocytopenia could be the most important surgical indication. Prematurity, low birth weight and thrombocytopenia were related to a bad prognosis. NEC patients who presents with these findings must be considered for close observation and intensive care.

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Atypical Hemolytic Uremic Syndrome after Traumatic Rectal Injury: A Case Report

  • Kang, Ji-Hyoun;Lee, Donghyun;Park, Yunchul
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.299-304
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    • 2021
  • Atypical hemolytic uremic syndrome (aHUS) is a rare, progressive, life-threatening condition of thrombotic microangiopathy characterized by thrombocytopenia, microangiopathic hemolytic anemia, and renal impairment. The mechanisms underlying aHUS remain unclear. Herein, we present the first case in the literature of aHUS after a traumatic injury. A 55-year-old male visited the emergency department after a traumatic injury caused by a tree limb. Abdominal computed tomography revealed a rectal wall defect with significant air density in the perirectal space and preperitoneum, implying rectal perforation. Due to the absence of intraperitoneal intestinal perforation, we performed diverting sigmoid loop colostomy. An additional intermittent simple repair was performed due to perianal and anal injuries. One day postoperatively, his urine output abruptly decreased and serum creatinine level increased. His platelet level decreased, and a spiking fever occurred after 2 days. The patient was diagnosed with acute renal failure secondary to aHUS and was treated with fresh frozen plasma replacement. Continuous renal replacement therapy (CRRT) was also started for oliguria and uremic symptoms. The patient received CRRT for 3 days and intermittent hemodialysis thereafter. After hemodialysis and subsequent supportive treatment, his urine output and renal function improved. The hemolytic anemia and thrombocytopenia also gradually improved. Dialysis was terminated on day 22 of admission and the patient was discharged after recovery. This case suggests that that a traumatic event can trigger aHUS, which should be considered in patients who have thrombocytopenia and acute renal failure with microangiopathic hemolytic anemia. Early diagnosis and appropriate management are critical for favorable outcomes.

COVID-19 vaccine-induced immune thrombotic thrombocytopenia: a review

  • Siti Nur Atikah Aishah Suhaimi;Izzati Abdul Halim Zaki;Zakiah Mohd Noordin;Nur Sabiha Md Hussin;Long Chiau Ming;Hanis Hanum Zulkifly
    • Clinical and Experimental Vaccine Research
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    • v.12 no.4
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    • pp.265-290
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    • 2023
  • Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

The Management of Heparin-induced Thrombocytopenia with Thrombosis That Developed after Aortic Dissection Surgery (대동맥 박리증 수술 후 발생한 혈전증을 동반한 헤파린 기인성 혈소판 감소증의 치료)

  • Kim, Jae-Bum;Park, Nam-Hee;Choi, Sae-Young
    • Journal of Chest Surgery
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    • v.43 no.5
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    • pp.538-541
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    • 2010
  • Heparin-induced thrombocytopenia (HIT) is a clinicopathologic condition and adverse drug reaction caused by immunoglobulin G (IgG) antibodies directed against the heparin-platelet factor 4 complex. HIT with thrombosis (HITT) could lead to limb amputation, stroke, myocardial infarction, and death. We report on the successful management of a HITT patient with argatroban therapy.

Epidemiological and Clinical Characteristics of Confirmed Cases of Severe Fever With Thrombocytopenia Syndrome in Jeju Province, Korea, 2014-2018

  • Kim, Jinhee;Bae, Jong-Myon
    • Journal of Preventive Medicine and Public Health
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    • v.52 no.3
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    • pp.195-199
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    • 2019
  • Objectives: Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province. Methods: The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018. Results: Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively. Conclusions: Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.

Evans' Syndrome Induced by Rabies Vaccination in a Dog

  • Yeji Kim;Jihyun Kim;Yunji Song;Songju Oh;Ha-Jung Kim
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.288-293
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    • 2023
  • A 11-year-old neutered male Maltese dog was vaccinated with a rabies vaccine (Rabisin®, Boehringer Ingelheim International GmbH, Germany) subcutaneously at a local animal hospital. One hour after vaccination, purpura with edema was observed at the injection site and severe thrombocytopenia (0 K/μL) was noted on a complete blood count (CBC). No specific findings were found in serum chemistry, electrolyte, blood gas analysis, and coagulation tests. The patient was hospitalized and administered antihemorrhagic agents (vitamin K, desmopressin), antihistamines (chlorpheniramine) and corticosteroids (methylprednisolone sodium succinate). On a repeat CBC, mild anemia had developed, thrombocytopenia was still noted, and autoagglutination was observed on a saline agglutination test (SAT). A polymerase chain reaction panel for infectious agents (e.g., Babesia spp.) was negative. The diagnosis was secondary immune-mediated thrombocytopenia (IMT) with immune-mediated hemolytic anemia (IMHA) associated with vaccination. Therefore, the immunosuppressants (prednisolone, and mycophenolate mofetil) were administered. Six days after drug administration, new lesion was not observed, and the previous lesions were significantly improved. It gradually improved and 4 weeks after hematocrit and platelet recovered to normal levels. It was maintained for 6 months without recurrence of related symptoms. Based on patient's history and test results, the patient was diagnosed with Evans' syndrome associated with rabies vaccine.

A Clinical Study on Juheli (Recombinant Human Interleukin - 11) in the Second Prevention of Chemotherapy Induced Thrombocytopenia

  • Xiao, Yang;Liu, Jun;Huang, Xin-En;Guo, Jian-Xiong;Fu, Peng-Chao;Huang, Xiao-Hong;Zhou, Juan;Ye, Ai-Qin
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.485-489
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    • 2016
  • Objective: to investigate the effect and side effects of recombinant human interleukin - 11 (rhIL - 11, in Chinese Juheli, produced by Qi Lu Biotechnology CO., LTD) in the second prevention of chemotherapy induced thrombocytopenia (CIT). Methods: Cancer patients with CIT were recruited and were treated with rhIL - 11 (treatment phase, TP), and in the following cycle, all these patients administered with rhIL - 11 24 hours immediately after chemotherapy (preventive treatment phase, PTP). Duration and severity of thrombocytopenia between two phases were compared. Results: for patients in TP or PTP, nadir values of platelet were ($29.28{\pm}20.08){\times}10^9/L$ and ($45.24{\pm}19.66){\times}10^9/L$, duration of thrombocytopenia in TP and PTP was ($11.52{\pm}4.33$) and ($8.20{\pm}+2.77$)days, recovery time was ($19.40{\pm}3.89$)and ($13.44{\pm}3.02$)days, duration of rhIL - 11 administration was ($10.68{\pm}2.46$)and ($6.28{\pm}1.77$)days, number of patients needing platelet infusion was 16and4 respectively, all differences were statistically significant (p value were 0.007, 0.002, 0.000, 0.000, 0.034 respectively). For TP and PTP, number of patients with hemorrhage was 8 and 4, duration of bleeding was ($5.00{\pm}0.82$) and ($4.50{\pm}0.71$) days respectively, with no statistically significant difference. Adverse reactions mainly included fever, edema, arrhythmia, joint pain, fatigue, skin rash, headache, dizziness, etc., all were not statistically significant between TP and PTP. Conclusion: rhIL - 11 could be well tolerated and is effective that could reduce the duration, severity of CIT, platelet transfusion, and incidence of bleeding, as well as shorten the recovery time, duration of rhIL - 11 administration. Thus, rhIL - 11 could be commended in the second prevention of CIT for patients with cancer.

A Case of Tuberculosis-associated Hemophagocytic Syndrome during Antituberculosis Medication for Tuberculous Pericarditis (결핵성 심막염으로 항결핵약을 복용하던 중 발생한 혈구 탐식증후군 1예)

  • No, Jin Hee;Kang, Ji Young;Lee, Bo Hee;Kim, Yun Ji;Lee, Jung Eun;Min, Jin Soo;Kang, Min Kyu;Kim, Kyung Hee;Yoon, Hyoung Kyu;Song, Jeong Sup
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.522-526
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    • 2008
  • A 63-year old woman was admitted to our hospital for an evaluation of thrombocytopenia. She had been diagnosed with tuberculous pericarditis three months earlier in a local clinic and treated with anti-tuberculosis medication. Two months later, thrombocytopenia developed. The medication was subsequently stopped because it was suspected that the anti-tuberculosis medication, particularly rifampin, might have caused the severe platelet reduction. However, the thrombocytopenia was more aggravated. A bone marrow biopsy was performed, which showed moderate amounts of histiocytes with active hemophagocytosis. This finding strongly suggested that the critical thrombocytopenia had been caused by hemophagocytic syndrome, not by the side effects of the anti-tuberculosis medication. Furthermore, the development of hemophagocytosis might have been due to an uncontrolled tuberculosis infection and its associated aberrant immunity. Therefore, she was started with both standard anti-tuberculosis medication and chemotherapy using etoposide plus steroid. One month after the initiation of treatment, the thrombocytopenia had gradually improved and she was discharged in a tolerable condition. At the third month of the follow-up, her platelet level and ferritin, the activity marker of hemophagocytic syndrome, was within the normal range.

No Detection of Severe Fever with Thrombocytopenia Syndrome Virus from Ixodid Ticks Collected in Seoul

  • Ham, Heejin;Jo, Sukju;Jang, Jungim;Choi, Sungmin
    • Parasites, Hosts and Diseases
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    • v.52 no.2
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    • pp.221-224
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    • 2014
  • Larvae, nymphs, and adult stages of 3 species of ixodid ticks were collected by tick drag methods in Seoul during June-October 2013, and their infection status with severe fever with thrombocytopenia syndrome (SFTS) virus was examined using RT-PCR. During the period, 732 Haemaphysalis longicornis, 62 Haemaphysalis flava, and 2 Ixodes nipponensis specimens were collected. Among the specimens of H. longicornis, the number of female adults, male adults, nymphs, and larvae were 53, 11, 240, and 446, respectively. Ticks were grouped into 63 pools according to the collection site, species, and developmental stage, and assayed for SFTS virus. None of the pools of ticks were found to be positive for SFTS virus gene.