• Title/Summary/Keyword: Thrombocytopenia

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A Case of Infectious Mononeucleosis Associated with Pleural Effusion (흉막 삼출액을 동반한 전염성 단핵구증 1례)

  • Lee, Yoon Hee;Noh, Jae Ho;Park, Il Sung;Jeoung, Kyung Sik;Kim, Chun Dong;Kim, Chang Hwi
    • Pediatric Infection and Vaccine
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    • v.13 no.2
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    • pp.191-195
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    • 2006
  • Infectious mononucleosis(IM) is a clinical syndrome characterized by fever, exudative tonsillitis, gerneralized lymphadenopathy(90% of cases), splenomegaly(50% of cases), and hepatomegaly(10% of cases). It is mainly caused by Epstein-Barr virus(EBV) and usually recovered completely in the majority of cases. The complications of IM are splenic rupture, pancreatitis, hematologic problems such as hemolytic anemia, aplastic anemia, and thrombocytopenia, neurologic problems such as meningitis, encephalitis, and Guillian-Barr$\acute{e}$ syndrome, myocarditis, parotitis, orchitis, and interstitial pneumonitis, etc. Pulmonary involvement with EBV infection is rare condition reported frequency of 3% to 5%, in addition pleural effusion has been very rarely reported, especially in the pediatric population. We herein report a case of IM with pleural effusion in 3 years old boy with fever, cervical lymphnodes enlargement, and hepato-splenomegaly. And the pleural effusion is spontaneously resolved for a hospitalization period. A brief review of literature is included.

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Therapeutic Effects of Atovaquone/Proguanil in Combination with Azithromycin in Dogs Naturally Infected with Babesia gibsoni (Babesia gibsoni 자연 감염개에서의 Atovaquone/Proguanil 합제와 Azithromycin 병용투여에 따른 치료효과)

  • Lee, Dae-Keun;Kim, Yun-Gi;Yun, Young-Min;Lee, Kyoung-Kap
    • Journal of Veterinary Clinics
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    • v.33 no.1
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    • pp.16-20
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    • 2016
  • This study was performed to estimate the clinical use of combination therapy with atovaquone/proguanil and azithromycin as a effective treatment in dogs infected with Babesia gibsoni. Eight mixed-breed dogs that were infected naturally with B. gibsoni were used in this study. Four dogs (No. 1-4) as experimental group received atovaquone/proguanil and azithromycin therapy. As for the other four dogs as the control group (No. 5-8) were administered diminazene aceturate and tetracycline/clindamycin. All the dogs in this study showed mild to severe anemia and thrombocytopenia. After initiating the treatment B. gibsoni in blood smears disappeared. PCR analysis of the experimental group showed negative results during the observation period, but more than one dog from the control groups showed continuous positive results. Atovaquone/proguanil and azithromycin combination therapy can significantly lower the B. gibsoni parasitemia levels and the results suggested that this combination therapy should be a new protocol for an effective treatment in dogs infected with B. gibsoni.

Diagnosis of Anaplasmosis by PCR and Long Term Medication in a Dog (PCR을 이용한 개의 아나플라즈마병 진단과 장기간 치료)

  • Lee Sook-jin;Lee Mi-jin;Chae Joon-seok;Na Ki-jeong
    • Journal of Veterinary Clinics
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    • v.22 no.2
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    • pp.170-173
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    • 2005
  • A 4-year-old female Shunauzer dog was referred to the Veterinary Teaching Hospital of Chungbuk National University due to anorexia and depression. The dog had a history of regular walking on grass fields, weight loss, and hyperthermia $(40.6^{\circ}C)$. In the physical examination, lymph node enlargement was confirmed. Complete blood count result revealed leukocytosis and thrombocytopenia but there was no decreasing of red blood cells. On blood chemistry, serum ALP, GGT, CPK, and LDH were elevated. Abdominal radiograph showed splenomegaly. Anaplasma platys infection was suspected with inclusion body-like substances in platelets on blood smear. Anaplasma platys was confirmed by PCR. On the basis of laboratory examination, final diagnosis was anaplasmosis. Treatment was followed for 3 months with tetracycline and doxycycline. The patient was monitored every week during the treatment. The patient has recovered to normal condition without any clinical signs. We are going to emphasize the need of PCR technique in diagnosis and to report the possibility of long term treatment more than two months in rickettial disease.

Systemic Lupus Erythematosus in a Dog, Suspexted Systemic Lupus Erythematosus in a Dog, and Autoimmune Thrombocytopenic Purpura Hemorrhagica in a Dog (개에 있어서 전신성홍반성루프스 1예와 전신성혼반성루프스 의증 1예 및 자가면역성혈소판감소성출혈성자반병 1예)

  • 이창우;나기정;임정식;서정욱
    • Journal of Veterinary Clinics
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    • v.13 no.1
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    • pp.81-86
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    • 1996
  • Systemic lupus erythematosus in a dog, suspected systemic lupus erythematosus in a dog, and autoimmune thrombocytopenic purpura hemmorrhagica in a dog are reported. A fice-year old, female Chihuahua (Case 1) showed initially hemorrhagic diathesis and purpura hemorrhagica. Afterward, it showed polymyositis and polyarthritis. LE-cell was demonstrated on LE-cell preparation trom blood. Systemic lupus erythematosus was diagnosed. This reponded well to the immunosuppressants, but developed iatrogenic Cushing syndrome and steroid hepatopathy. A two-and-half-year old, male toy poodle (Case 2) had chief complaint of red urine. Occult blood test for the urine sediment. This did not respond at all to antibiotics and carbazochrome, which is one of systemic coagulants. LE-cell was demonstrated on LE-cell preparation from blood. This responded relatively well to immunosupressants such as prenisolone, azathioprine and cyclophosphamide. systemic lupus erythematosus is suspected. A nine-year-and-three-month old, female Maltese (Case 3), which had history of congestive heart failure and ovariohysterectomy showed purpura hemorrhagica in the skin of chest. This had severe thrombocytopenia and leukocytosis. As prednisolone was administered before immunological examination or demonstration of LE-cell, it was impossible to diagnose whether purpura hemorrhagica developed as a member of systemic lupus erythematosus or independent of systemic lupus erythematosus. This responded well to prednisolone, and so autoimmune thrombocytopenic purpura hemorrhagica was diagnosed.

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1q21.1 microdeletion identified by chromosomal microarray in a newborn with upper airway obstruction

  • Kim, Yoon Hwa;Yang, Ju Seok;Lee, Young Joo;Bae, Mi Hye;Park, Kyung Hee;Lee, Dong Hyung;Shin, Kyung-Hwa;Kim, Seung Chul
    • Journal of Genetic Medicine
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    • v.15 no.1
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    • pp.34-37
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    • 2018
  • A 1q21.1 microdeletion is an extremely rare chromosomal abnormality that results in phenotypic diversity and incomplete penetrance. Patients with a 1q21.1 microdeletion exhibit neurological-psychiatric problems, microcephaly, epilepsy, facial dysmorphism, cataract, and thrombocytopenia absent radius syndrome. We reported a neonate with confirmed intrauterine growth restriction (IUGR), micrognathia, glossoptosis, upper airway obstruction, facial dysmorphism, and eye abnormality at birth as well as developmental delay at the age of 1 year. These clinical manifestations, except for the IUGR and upper airway obstruction, in the neonate indicated a 1q21.1 microdeletion. Here, we report a rare case of a 1q21.1 microdeletion obtained via paternal inheritance in a newborn with upper airway obstruction caused by glossoptosis and tracheal stenosis.

Study on Cancer Patients Who Visited an Emergency Department with the Side Effects of Chemotherapy (응급실 내원 암환자의 항암화학요법 부작용에 대한 후향적 조사연구)

  • Lim, Soo Jung;Yi, Myungsun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.75-89
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    • 2014
  • Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

Experimental Study on the Effect of L-Glutamate to Acute Myocardial Toxicity by Doxorubicin (Doxorubicin 에 의한 급성 심근독성과 L-Glutamate 의 효과에 관한 실험적 연구)

  • Park, Seong-Dal;Kim, Song-Myeong;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.22 no.3
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    • pp.436-447
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    • 1989
  • The effect of Glutamate to myocardial toxicity induced by doxorubicin was studied with 20 male rats. 20 rats divided into 4 subgroups, 1st group was taken for normal control group without any treatment, 2nd group was injected with only doxorubicin, 3rd group was injected with L-glutamate and doxorubicin, and 4thd group was injected with only L-glutamate [all injections were done intraperitoneally]. Observations were made to each group on their gross findings, body weight, and electrocardiography, complete blood count and serum level of creatine phosphokinase. The results were as follows; l. In 1st group, we found no changes. 2. In 2nd group, there were many changes which were loss of body weight, dehydration, loss of body hair, diarrhea and death, in addition, elevation of CPK-MB isoenzyme and changes in EKG due to myocardial damage, leukopenia, thrombocytopenia were also found. 3. In 3rd group, there were more toxic effects containing 2 death cases, compared to 2nd group. 4. In 4th group, we found no specific changes except weight gain. These results suggest that L-glutamate which is intermediate of Krebs cycle may worsen the doxorubicin-induced myocardial toxicity.

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Infectious Cholecystitis and Concurrent Endocarditis in a Dog: Rare but Important Association (개에서 감염성 담낭염과 동시 발병한 감염성 심내막염 1례)

  • Jung, Joohyun;Choi, Mincheol
    • Journal of Veterinary Clinics
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    • v.32 no.4
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    • pp.338-342
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    • 2015
  • A 12-year-old castrated male miniature Schnauzer had anorexia, vomiting, lethargy, and fever for four days. The dog had leukocytosis, thrombocytopenia, hypoglycemia, hypoalbuminemia, hyperbilirubinemia, increased hepatic enzymes on hematologic and biochemical examinations. On abdominal ultrasonographs, there was an enlarged gallbladder with hyperechoic irregular wall thickening. Echocardiography showed vegetative change and regurgitation of aortic and mitral valves. E.coli was identified through ultrasound guided percutaneous cholecystocentesis and bile culture. Bacterial cholecystitis and concurrent endocarditis were diagnosed. The dog was recovered from sepsis with antibacterial and aggressive supportive therapy.

Treatment of Snakebite Wound in a Dog (개에서 발생한 독사 교상 치료 1례)

  • Park, Ji-Young;Lee, Jae-Yeon;Jee, Hyun-Chul;Park, Seong-Jun;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.449-452
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    • 2007
  • A 2 year-old intact male Shih-tzu dog was presented with a history of snakebite on the left upper lip. He was depressed and had swelling, erythema and pain around the left muzzle. Both mandibular lymph nodes were swollen. Fang marks were not clear, but there were scratch wounds and prolonged bleeding. Hemogram revealed neither thrombocytopenia nor echinocytosis. Increased CK value in serum chemistry and myoglobinuria in urine analysis meant muscle injury. With careful monitoring, fluid, corticosteroid, antihistamine and antibiotics were administered. After the application of ice pack and suction, local symptoms changed for the worse. However, any other systemic disorders were not identified. After 5 days, the facial swelling had resolved completely.

Dose Intensity of Oxaliplatin in 5-Fluorouracil and Leucovorin Regimens in Pretreated Metastatic Colorectal Cancer (5-Fluorouracil, Leucovorin과 병용 투여된 Oxaliplatin의 Dose Intensity가 재발된 전이성 대장암 치료에 미치는 영향)

  • Jeong, Kyong-Ju;Choi, Seung-Ki;Oh, Jung-Mi
    • Korean Journal of Clinical Pharmacy
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    • v.14 no.1
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    • pp.1-10
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    • 2004
  • Studies of oxaliplatin, 5-fluorouracil and leucovorin in pretreated metastatic colorectal cancer showed that oxaliplatin dose intensity is important prognostic factor for objective response rates and progression-free-survival (PFS). To evaluate response rates, PFS and toxicity according to oxaliplatin dose intensity, we retrospectively analyzed data from patients with metastatic colorectal cancer received oxaliplatin,5-fluorouracil, leucovorin regimens. Sixty-three patients were reviewed in this study, 42 patients received low dose intensity oxaliplatin (LDI: $\leq85\;mg/m^2/2wks$) and 21 patients high dose intensity oxaliplatin (HDI: $>85\;mg/m^2/2wks$). Objective responses occurred in 10 $(47.7\%)$ HDI patients and 9 $(21.4\%)$ LDI patients (p = 0.014). Median PFS was 24.7 weeks in HDI group, with $45.1\%$ of HDI patients progression free at 6 months, and 20.5 weeks in LDI group, with $33.5\%$ of LDI patients progression free at 6 months (p = 0.344). Increased oxaliplatin dose intensity was not associated with neutropenia, thrombocytopenia, neuropathy, nausea and vomiting. This study showed that oxaliplatin dose intensification significantly improves objective response rate in pretreated metastatic colorectal cancer without increasing severe toxicity.

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