• 대한수의학회지
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• 제55권4호
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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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• 제46권3호
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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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• 제38권2호
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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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• 제4권1호
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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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• 제49권8호
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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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• 제23권1호
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• pp.72-76
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• 2016

골화석증은 골격의 경화증이 특징적으로 나타나는 드문 유전 질환으로 뼈 흡수 기전에 손상이 오며 조기 사망하는 질환이다. 반면 거대세포바이러스 감염은 가장 흔한 선천성 감염 중 하나로 빈혈, 혈소판 감소증과 간비장종대, 뇌 석회화 등이 나타날 수 있다. 심한 간비비대, 혈소판 감소증 및 저칼슘혈증과 발달지연으로 내원한 환자에서 두 가지 질환이 함께 있어 항바이러스제 치료 및 대증치료를 시행하였고, 치료 반응이 빠르게 나타나지는 않았으나 지속적인 치료 결과 대부분의 수치가 정상화 되는 것을 확인하였다. 본 증례는 골화석증 신생아에게 동반된 거대세포바이러스 감염의 첫 증례 보고로, 거대세포바이러스 감염에 대한 항바이러스제의 장기 치료로 호전된 사례이다.

• 한국산학기술학회논문지
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• 제18권7호
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• pp.565-568
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• 2017

쇼그렌 증후군은 입안 건조와 호중성백혈구 감소증을 주로 보이는 자가면역질환이다. 일반적으로 쇼그렌 증후군은 중추신경계를 잘 침범하지 않는 것으로 알려져 있다. 하지만 드물게, 쇼그렌 증후군에서 미세혈관병성 변성이 생기고, 이로 인해 소혈관에 영향을 미치기도 한다. 34세의 여자 환자가 왼쪽 위사분맹 및 왼쪽 팔다리의 저린 증상이 있어 내원하였다. 뇌자기공명영상에서 오른쪽 후대뇌동맥 영역의 급성 뇌경색 소견이 확인되었다. 혈액학적 검사는 항핵항체 (FANA2+) 및 항DNA항체 (anti-SS-A (RO)) 양성이었다. 그리고 침샘 섬광조영술에서 타액 분비양이 현저히 저하되었다. 따라서 환자는 쇼그렌 증후군으로 진단할 수 있었다. 본 환자의 경우처럼 쇼그렌 증후군에서 대혈관을 침범하는 것은 매우 드문 일이다. 또한 쇼그렌 증후군 환자가 저혈소판증을 보였을 경우, 항혈소판 제재를 쓰는 것이 어려울 수 있다. 이 연구는 대혈관 침범 및 저혈소판증을 보인 쇼그렌 증후군 환자에서 항혈소판 제재 및 하이드록시클로로퀸을 통한 성공적인 치료와, 이와 관련된 임상 양상 및 병태생리를 보고한 사례연구이다.

• Journal of Chest Surgery
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• 제51권3호
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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.

• 대한수의학회지
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• 제47권4호
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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.

• 한국동물위생학회지
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• 제39권2호
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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.