• Title/Summary/Keyword: Thrombocytopenia

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Congenital and perinatal cytomegalovirus infection

  • Kim, Chun Soo
    • Clinical and Experimental Pediatrics
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    • v.53 no.1
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    • pp.14-20
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    • 2010
  • Cytomegalovirus (CMV) is currently the most common agent of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Symptomatic congenital CMV infections usually result from maternal primary infection during early pregnancy. One half of symptomatic infants have cytomegalic inclusion disease (CID), which is characterized by involvement of multiple organs, in particular, the reticuloendothelial and central nervous system (CNS). Moreover, such involvement may or may not include ocular and auditory damage. Approximately 90% of infants with congenital infection are asymptomatic at birth. Preterm infants with perinatal CMV infection can have symptomatic diseases such as pneumonia, hepatitis, and thrombocytopenia. Microcephaly and abnormal neuroradiologic imaging are associated with a poor prognosis. Hearing loss may occur in both symptomatic and asymptomatic infants with congenital infection and may progress through childhood. Congenital infection is defined by the isolation of CMV from infants within the first 3 weeks of life. Ganciclovir therapy can be considered for infants with symptomatic congenital CMV infection involving the CNS. Pregnant women of seronegative state should be counseled on the importance of good hand washing and other control measures to prevent CMV infection. Heat treatment of infected breast milk at $72{^{\circ}C}$ for 5 seconds can eliminate CMV completely.

A Case of Evans Syndrome Treated through Oriental Medicine (한방적 치료 접근을 통한 Evans 증후군 치험 1례)

  • Park, Sang-Eun;Choi, In-Sun;Jang, Ja-Won;Hong, Sang-Hoon;Seo, Sang-Ho
    • The Journal of Internal Korean Medicine
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    • v.25 no.3
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    • pp.573-581
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    • 2004
  • Evans syndrome, as originally described, refers to autoimmune hemolytic anemia accompanied by thrombocytopenia. The autoantibodies in Evans syndrome are directed specifically against red cells, platelets, or neutrophils and are not crossreacting. The incidence of autoimmune hemolytic anemia is estimated to be approximately 10 cases per million people. Many patients have associated disorders, such as lupus erythematosus and other autoimmune disease, chronic lymphadenopathy, or hypogammaglobulinemia. In Oriental Medicine, the approach to Evans syndrome is made in view of deficiency of blood. The ailment was treated through methods of Oriental Medicine. Acupucture and herbal medicine were administered to patients diagnosed with Evans Syndrome by ecchymosis at the lower limb after continued gingival bleeding. As a result significant improvement in RBC, Hb, Hct, and PLT were observed and complaints abated.

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A Case of Idiopathic Portal Hypertension in a 3-year-old Girl (3세 여아에서 진단된 특발성 문맥 고혈압 1예)

  • Son, Ki-Young;Baek, Seoung-Yon;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.2
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    • pp.221-225
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    • 2007
  • A previously healthy 3-year-old girl was admitted to the Department of Pediatrics in Severance Hospital with sudden symptoms of melena. The vital signs were stable, and splenomegaly was found in a physical examination. The patient had moderate thrombocytopenia. There was no evidence of autoimmune disease. A upper gastrointestinal endoscopy and esophagogram showed a varix on the lower esophagus. Coarse liver parenchymal echoes and increased periportal echogenicity were seen on a Doppler sonogram. The velocity of the portal vein mildly increased. Magnetic-resonance-cholangiopancreatogram (MRCP) demonstrated normal portal structures. A sono-guided liver biopsy was performed, but the pathological findings were unremarkable. Based on these findings, we diagnosed the patient with idiopathic portal hypertension. The patient was discharged and was treated with oral beta blocker. We report a case of idiopathic portal hypertension with a brief review of the literature.

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Leukemic Oral Manifestations and their Management

  • Francisconi, Carolina Favaro;Caldas, Rogerio Jardim;Martins, Lazara Joyce Oliveira;Rubira, Cassia Maria Fischer;da Silva Santos, Paulo Sergio
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.911-915
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    • 2016
  • Leukemia is the most common neoplastic disease of the white blood cells which is important as a pediatric malignancy. Oral manifestations occur frequently in leukemic patients and may present as initial evidence of the disease or its relapse. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections. Oral lesions arise in both acute and chronic forms of all types of leukemia. These oral manifestations either may be the result of direct infiltration of leukemic cells (primary) or secondary to underlying thrombocytopenia, neutropenia, or impaired granulocyte function. Despite the fact that leukemia has long been known to be associated with oral lesions, the available literature on this topic consists mostly of case reports, without data summarizing the main oral changes for each type of leukemia. Therefore, the present review aimed at describing oral manifestations of all leukemia types and their dental management. This might be useful in early diagnosis, improving patient outcomes.

Retrospective Study of Gemcitabine Based Chemotherapy for Unresectable or Recurrent Esophagus Squamous Cell Carcinoma Refractory to First Line Chemotherapy

  • Wang, Mei;Gu, Jun;Wang, Hai-Xing;Wu, Mei-Hong;Li, Yong-Mei;Wang, Ya-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.8
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    • pp.4153-4156
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    • 2012
  • Purpose: To investigate the efficacy and toxicity of a combination of gemcitabine with nedaplatin (GN) or cisplatin (GC) for patients with unresectable or recurrent esophagus squamous cell carcinoma. Methods: Gemcitabine was administered at 1 g/m2 intravenously on days 1 and 8; and nedaplatin or cisplatin were administered at 80 mg/m2 intravenously on day 1. We analyzed the response rate, overall survival time, progression-free survival time, and toxicity in 21 patients treated with GN and 27 patients treated with GC. Results: In patients treated with gemcitabine plus nedaplatin, the ORR was 47.6%, the median progression-free survival time was 4.1 months, and the median survival time was 9.3 months. In patients treated with gemcitabine plus cisplatin, the ORR was 48.2%, the median progression-free survival time was 3.9 months, and the median survival time was 9.1 months, respectively. There were no statistically significant differences in ORR, PFS and OS between the two groups. In both, the most commonly observed toxicities were thrombocytopenia and fatigue. Nausea and vomiting was more frequent in the GC group than in the GN group. Conclusion: Gemcitabine based chemotherapy was effective and tolerable for patients with unresectable or recurrent esophagus squamous cell carcinoma refractory to first line chemotherapy.

Gemcitabine for the Treatment of Patients with Osteosarcoma

  • Wei, Mei-Yang;Zhuang, Yan-Feng;Wang, Wan-Ming
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7159-7162
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    • 2014
  • Background: Patients with recurrent or refractory osteosarcoma are considered to have a very poor prognosis, and new regimens are needed to improve the prognosis in this setting. Gemcitabine, a nucleoside antimetabolite, is an analog of deoxycytidine which mainly inhibits DNA synthesis through interfering with DNA chain elongation and depleting deoxynucleotide stores, resulting in gemcitabine-induced cell death. Here we performed a systemic analysis to evaluate gemcitabine based chemotherapy as salvage treatment for patients with recurrent or refractory osteosarcoma. Methods: Clinical studies evaluating the impact of gemcitabine based regimens on response and safety for patients with osteosarcoma were identified by using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In gemcitabine based regimens, 4 clinical studies which included 66 patients with recurrent or refractory osteosarcoma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 12.1% (8/66) in gemcitabine based regimens. Major adverse effects were hematologic toxicity, including grade 3 or 4 anemia, leucopenia and thrombocytopenia in gemcitabine based treatment. No treatment related death occurred in gemcitabine based treatment. Conclusion: This systemic analysis suggests that gemcitabine based regimens are associated with mild activity with good tolerability in treating patients with recurrent or refractory osteosarcoma.

Clinical Study on Carboplatin for Treating Pediatric Patients with Wilms Tumors

  • Zhang, Yong;Sun, Ling-Li;Li, Tao;Sun, Hui;Mao, Guo-Jia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.17
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    • pp.7277-7280
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    • 2014
  • This analysis was conducted to evaluate the efficacy and safety of carboplatin based chemotherapy in treating pediatric patients with Wilms tumors. Methods: Clinical studies evaluating the efficacy and safety of carboplatin based regimens on response and safety for pediatric patients with Wilms tumors were identified using a predefined search strategy. Pooled response rates (RRs) of treatment were calculated. Results: In carboplatin based regimens, 4 clinical studies which including 127 patients with advanced Wilms tumors were considered eligible for inclusion. With this carboplatin based chemotherapy, 2 clinical studies included carboplatin, ifosfamide and etoposide. Systemic analysis suggested that, in all patients, the pooled PR was 64.5% (82/127) in carboplatin based regimens. Thrombocytopenia and leukocytopenia were the main side effects. No grade III or IV renal or liver toxicity was observed. No treatment related death occurred with carboplatin based treatment. Conclusion: This systemic analysis suggests that carboplatine based regimens are associated with a reasonable response rate and accepted toxicities for treating pediatric patients with Wilms tumors.

A Case of Hemolytic Uremic Syndrome Induced by Pneumococcal Infection (폐구균 감염으로 유발된 용혈성 요독 증후군 ( Hemolytic Uremic Syndrome) 1례)

  • Sim Yoon-Hee;Choi Eung-Sang;Lim In-Seok
    • Childhood Kidney Diseases
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    • v.6 no.2
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    • pp.237-242
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    • 2002
  • Hemolytic Uremic Syndrome (HUS) is the most common cause of acute renal failure in children and is comprised of the combination of hemolytic anemia, thrombocytopenia, and acute renal failure. Atypical HUS, rare in childhood, has worse prognosis than that of typical HUS and is associated with chemotherapy drug, other bacterial (especially Streptococcus pneumoniae) or viral infections, and so on. We report a case of HUS caused by pneumococcal infection in 4-year-old boy. While he was admitted with pneumonia and pleural effusion, pneumococcal infection could be revealed. Although HUS progressed rapidly, he immediately received 3-time hemodialysis and recovered completely after two weeks.

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A Case of Unilateral Renal Lymphosarcoma in a Dog (개에서의 편측성 신장 림프육종 1예)

  • Cheong, Jongtae;Kim, Jae-Hoon;Yoon, Young-Min;Lee, Joo-Myoung;Kang, Tae-Young;Ko, Kyu-Ryeon;Park, Hyun-Jung
    • Journal of Veterinary Clinics
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    • v.31 no.1
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    • pp.73-76
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    • 2014
  • A 10-year-old, female spayed mixed-breed dog with a history of vomiting and anorexia was examined. Abnormal findings of comlete blood count and serum chemistry included polycythemia, thrombocytopenia, hyper-globulinemia and hypoalbuminemia. Abdominal radiographs revealed severe unilateral renomegaly, and ultrasonography showed a left-sided renal mass. During the operation, left kidney was resected. Cytologial and histopathological examinations revealed neoplastic lymphoid proliferation with high mitotic figures in renal mass. Immunohistochemistry revealed tumor cells were CD3-positive and CD79${\alpha}$-negative, consistent with T-cell lineage. The renal mass of this case was diagnosed as renal T cell lymphosarcoma.

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.