• 제목/요약/키워드: Thrombocytopenia

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

  • 강동원;곽금희;양근호;배병노;김기환;한세환;김홍주;김영덕;최명재
    • Advances in pediatric surgery
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    • 제14권2호
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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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    • 제34권4호
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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.

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

  • 김재범;박남희;최세영
    • Journal of Chest Surgery
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    • 제43권5호
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    • pp.538-541
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    • 2010
  • 헤파린 기인성 혈소판 감소증은 헤파린과 혈소판 제4인자 사이의 복합체에 대항하여 만들어진 면역글로불린-G 항체에 의해 발생한 약물 부작용이라고 할 수 있다. 혈전증을 동반한 헤파린 기인성 혈소판 감소증은 사지 절단이나 뇌졸증, 심근경색과 같은 병을 일으켜 사망에 이르게 할 수 있다. 저자들은 혈전증을 동반한 혈소판 감소증을 agatroban을 사용하여 성공적으로 치료하여 보고하는 바이다.

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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    • 제52권3호
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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
    • 한국임상수의학회지
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    • 제40권4호
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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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    • 제17권2호
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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.

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

  • 노진희;강지영;이보희;김윤지;이정은;민진수;강민규;김경희;윤형규;송정섭
    • Tuberculosis and Respiratory Diseases
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    • 제65권6호
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    • pp.522-526
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    • 2008
  • 결핵과 연관된 혈구 탐식 증후군은 매우 드물며 사망률이 50% 정도로 높은 질환이다. 저자들은 결핵성 심막염 진단 후 2달간 항결핵약을 복용하고 있는 환자에서 지속적인 혈소판 감소증을 보이고 골수검사에서 혈구탐식증을 보였으나 이전에 보고된 증례와는 다르게 경한 임상증상을 보이면서 항결핵약제 및 스테로이드와 etoposide의 병합 항암 치료에 빠른 호전을 보인 예를 경험하였기에 이를 문헌 고찰과 함께 보고하는 바이다.

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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    • 제52권2호
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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.

위나선균양성 특발성혈소판감소성자반증에서 위나선균박멸요법의 효과: 증례 연구 (The Effect of Helicobacter pylori eradication in Patients with H. pylori(+) Idiopathic thrombocytopenic Purpura : Case study)

  • 박치영;문홍섭
    • 한국임상약학회지
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    • 제21권1호
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    • pp.39-42
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    • 2011
  • Idiopathic thrombocytopenic purpura is a potentially life-threatening condition characterised by thrombocytopenia and mediated by an autoimmune mechanism. Several recent studies have suggested that an association exists between H. pylori eradication and improvement in platelet count in a significant proportion of patients with idiopathic thrombocytopenic purpura. This study confirmed the efficacy of H. pylori eradication in increasing the platelet count in steroid refractory idiopathic thrombocytopenic purpura patients. Eradication therapy is simple and inexpensive, with limited toxicity and the advantage of avoiding long-term immunosuppressive treatment.

HELLP 증후군 산모에서 무통분만을 위해 시행한 경막외 진통법 -증례 보고- (Epidural Analgesia for Labor Pain Management in a Parturient with HELLP Syndrome -A case report-)

  • 윤채식;이정윤;홍성주;이준학
    • The Korean Journal of Pain
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    • 제12권2호
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    • pp.253-257
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    • 1999
  • Hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, a variant presentation of severe preeclampsia/eclampsia is associated with high maternal morbidity and mortality. Despite several advantages to the use of epidural analgesia for the management of labor pain in preeclamptic parturients, this procedure is relatively contraindicated in the presence of severe thrombocytopenia. Determining the pain management of choice depends on the parturient's condition, fetal well-being, and the urgency of the situation. We report a safe case of epidural analgesia in a HELLP syndrome parturient with severe thrombocytopenia for labor pain management without any neurologic complications or epidural hematoma.

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