• Title/Summary/Keyword: Thrombocytopenia

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Comprehensive Laboratory Analysis of Korean Acute Alcoholic Intoxication Patients Reveals the Need for a National Hepatitis B Virus Vaccination Program in Korea

  • Shin, Sang-Yong
    • Korean Journal of Family Medicine
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    • v.39 no.6
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    • pp.360-363
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    • 2018
  • Background: Acute alcoholic intoxication patients (AAIP) are a common public health problem. The aim of this study was to perform a comprehensive laboratory analysis for these patients to investigate the co-morbid medical problem. Methods: We retrospectively reviewed laboratory findings of AAIP who were transferred to the emergency department (ED) from January 2017 to June 2017. Results: A total of 160 male patients were enrolled. Sixteen patients (16/160, 10.0%) and three patients (3/160, 1.9%) had macrocytic anemia and microcytic anemia, respectively. A total of 33 patients (33/160, 20.6%) showed thrombocytopenia ($<150{\times}10^9/L$). Twelve patients (12/159, 7.5%) showed low serum albumin level (<3.5 g/dL). Three patients (3/160, 1.9%) had chronic kidney disease stages 3-4 based on estimated glomerular filtration rate. Six patients (6/27, 22.2%) had high hemoglobin A1c (HbA1c) level (>7.0%). Positive rates of hepatitis B surface antigen and antiHBs antibody (anti-HBs Ab) were 3.5% (5/141) and 49.0% (68/141), respectively. Conclusion: Patients with AAIP who were transferred to ED had various laboratory abnormalities (anemia, thrombocytopenia, high HbA1c). They had low positive rate of anti-HBs Ab. This might be a public health problem, suggesting the need of hepatitis B virus vaccination program for AAIP. Our data suggest the need of further nationwide studies.

Bone Marrow Toxicity Caused by Estrogen Toxicity in a Yorkshire Terrier with Leydig Cell Tumor

  • Kim, Yoon-Hee;Ko, Kyu-Ryeon;No, Mi-Young;Kim, Jae-Hoon;Choi, Ul-Soo
    • Journal of Veterinary Clinics
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    • v.36 no.2
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    • pp.129-131
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    • 2019
  • A 15-year-old intact Yorkshire terrier was presented with anorexia, lethargy, and a pale mucous membrane. A physical examination one year ago revealed right testis mass and subcutaneous petechia. Blood work revealed severe thrombocytopenia and mild anemia, and no abnormalities were found in serum chemistry or ultrasonography. The preoperative serum estrogen concentration was moderately elevated. The enlarged testis was surgically removed. A well-encapsulated mass composed of polyhedral or round with abundant eosinophilic cytoplasm containing fine granular or vacuolation were found in a histological examination of the removed tissue. The nuclei of tumor cells were round, and mitotic figures were low but neoplastic cells showed a mild invasive tendency to adjacent tissues with contained neoplastic cell emboli in one lymphatic lumen. A diagnosis of a malignant Leydig cell tumor was made. The patient recovered from surgery uneventfully, but his condition worsened despite repeated transfusions and supportive therapy, and he was euthanized according to the owner's decision. Leydig cell tumor should be included in estrogen toxicity associated with testicular mass.

Nonstructural Protein of Severe Fever with Thrombocytopenia Syndrome Phlebovirus Inhibits TBK1 to Evade Interferon-Mediated Response

  • Lee, Jae Kyung;Shin, Ok Sarah
    • Journal of Microbiology and Biotechnology
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    • v.31 no.2
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    • pp.226-232
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    • 2021
  • Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging phlebovirus of the Phenuiviridae family that has been circulating in the following Asian countries: Vietnam, Myanmar, Taiwan, China, Japan, and South Korea. Despite the increasing infection rates and relatively high mortality rate, there is limited information available regarding SFTSV pathogenesis. In addition, there are currently no vaccines or effective antiviral treatments available. Previous reports have shown that SFTSV suppresses the host immune response and its nonstructural proteins (NSs) function as an antagonist of type I interferon (IFN), whose induction is an essential part of the host defense system against viral infections. Given that SFTSV NSs suppress the innate immune response by inhibiting type I IFN, we investigated the mechanism utilized by SFTSV NSs to evade IFNmediated response. Our co-immunoprecipitation data suggest the interactions between NSs and retinoic acid inducible gene-I (RIG-I) or TANK binding kinase 1 (TBK1). Furthermore, confocal analysis indicates the ability of NSs to sequester RIG-I and related downstream molecules in the cytoplasmic structures called inclusion bodies (IBs). NSs are also capable of inhibiting TBK1-interferon regulatory factor 3 (IRF3) interaction, and therefore prevent the phosphorylation and nuclear translocation of IRF3 for the induction of type I IFN. The ability of SFTSV NSs to interact with and sequester TBK1 and IRF3 in IBs demonstrate an effective yet unique method utilized by SFTSV to evade and suppress host immunity.

Editorial for Vol. 30, Issue 2 (편집자 주 - 30권 2호)

  • Kim, Young Hyo
    • Korean journal of aerospace and environmental medicine
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    • v.30 no.2
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    • pp.51-53
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    • 2020
  • In commemoration of Vol. 30, Issue 2, our journal prepared three review articles, two original papers, and a case report. The first review analyzed aircraft accidents caused by pilots' fatigue and presented a protocol to measure their fatigue, such as primary background survey, subjective drowsiness/arousal evaluation, sleep and activity log, sleep data, and performance measurement. The second review analyzed shift work patterns and work characteristics that may affect the fatigue of aviation mechanics. Also, desirable work principles for aviation mechanics (restrictions on working hours, appropriate rest hours, and night shift restrictions) were presented. The third review discussed the effects that allergic rhinitis can have on pilots (drowsiness and decreased arousal) and introduced a safe treatment method that can prevent these adverse effects. In the first original article, the ratio of 'incompatible (non-fit)' result in aerospace medical examination among Korean aircraft pilots for the past five years was investigated by age group and the common causes of nonconformity were analyzed. In the second original article, the prevalence, mortality, prevalence according to age groups, and regional characteristics of severe febrile thrombocytopenia syndrome were compared and analyzed in Korea and Japan for the past five years. Finally, in the case report, the cases of a patient diagnosed as gastrointestinal stromal tumors who received surgical treatment and chemotherapy were discussed, and the results of the judgment were presented.

Frequency of Platelet Transfusions and Outcome in Neonates with Thrombocytopenia (혈소판 감소증이 있는 신생아에서 혈소판 수혈 횟수와 예후)

  • Lim, Suk-Hwan;Kook, Jin-Hwa;Cho, Chang-Yee;Choi, Young-Youn;Hwang, Tai-Ju
    • Clinical and Experimental Pediatrics
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    • v.45 no.8
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    • pp.961-966
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    • 2002
  • Purpose : We compared the underlying or associated diseases according to the frequency of platelet transfusions in neonates with thrombocytopenia to know the factors predicting which patients will require multiple platelet transfusions. We also compared mortality. Methods : A retrospective study was performed in 72 neonates who received the platelet transfusions in neonatal intensive care unit(NICU) between August 1996 and July 2001. Group I received one platelet transfusion and group II received two or more. We compared the frequency of underlying or assodiated diseases such as sepsis/disseminated intravascular coagulopathy(DIC), respiratory distress syndrome(RDS), intraventricular hemorrhage(IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis(NEC), liver or renal disease, and mortality between two groups. Results : Of the 72 patients, 29(40.2%) received one and 43(59.7%) received two or more transfusions; 16(22.2%) received four or more. There were no statistically significant differences in gestational age, birth weight, sex, and maternal history between two groups. C-section rate was higher in group II(20.7% vs. 55.8%, P<0.05) and the incidence of PDA was higher in group I (55.2% vs. 30.2%, P<0.05). Otherwise, there were no statistically significant differences in the incidence of sepsis/DIC, RDS, IVH, RDS, CLD, NEC, liver or renal disease, pulmonary hemorrhage and hypoxic ischemic encephalopathy, and mortality between group I and group II. Conclusion : There was no significant difference in clinical morbidity and mortality according to the frequency of platelet transfusion in neonates with thrombocytopenia. Further study is needed to know the predicting factor for multiple platelet transfusions in neonates with thrombocytopenia.

Platelet Kinetics and Other Hematological Profiles in Experimental Plasmodium falciparum Infection: A Comparative Study between Saimiri and Aotus Monkeys (Plasmodium fulcipurum 감염 실험에 있어서의 혈소판과 혈액치의 변각 -Saimiri과 Aotus 원숭이의 비교 시험-)

  • Kakoma I.;Jam
    • Parasites, Hosts and Diseases
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    • v.30 no.3
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    • pp.177-182
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    • 1992
  • Levels of platelets and other hematological values were monitored in 21 Saimiri and 12 Aotus monkeys over a period of three weeks post·infection with monkey·adapted Indochina CDC-1 strain of Plasmedium falciparum. In both Snlinoiri sciureus boliviensis and Aetus nancymai karyotype-1 monkeys the severest thrombocytopenia was observed at 14 days post-infection coinciding with peak parasitemia, neutropenia, Iynlphocytosis, and anemia associated with severe hemoglobinemia and elevated fibrinogen degeneration products(FDP's), MCH and MCV profiles in Aotus monkeys decreased with ascending parasitemia. In contrast, these parameters in Saimiri were characterized by a significant compensatory increase correlating with parasitemia. In general, thrombocytopenia was one of the earliest clinical manifestations of the infection with the platelets returning to normal levels shortly after peak parasitenlia at 14 days. Platelet kinetics had a strong correlation with hematologic and parasitologic values in the Aotus nlodel. No consistent associations were observed between platelet kinetics and other parameters in the Saimiri model. These data indicate that the Aotus model for malaria is more predictable than the Saimiri. Further, platelet turnover rates and recovery provide a useful prognostic parameter during malaria infection. The results are discussed in relation to the value of the two species of monkeys as models for the pathogenesis of human malaria.

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Prevalence of severe fever with thrombocytopenia syndrome virus among ticks surveyed at Mt. Gwanak, Korea (관악산에서 참진드기 조사 및 중증열성혈소판감소증후군 바이러스 검출)

  • Chae, Jeong-Byoung;Kim, Tae-Hee;Jung, Jee-Ho;Park, Yoon-Ji;Park, Jin-Ho;Choi, Kyoung-Seong;Yu, Do-Hyeon;Park, Bae-Keun;Chae, Joon-Seok
    • Korean Journal of Veterinary Research
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    • v.57 no.3
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    • pp.169-174
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    • 2017
  • This study was performed to investigate the distribution of ticks and the rate of infection with severe fever with thrombocytopenia syndrome (SFTS) virus in ticks collected at Mt. Gwanak and the Seoul National University campus, Korea. Ticks (n = 273) were collected from May to October and included 76 Haemaphysalis longicornis (4 adult females, 72 nymphs), 49 Haemaphysalis flava (9 adult females, 3 adult males, 37 nymphs), and 148 Haemaphysalis spp. larvae. SFTS virus detection was performed by using one-step RT PCR and nested PCR. The SFTS virus was detected in 7 samples (1 Haemaphysalis longicornis nymph, 3 Haemaphysalis flava nymphs, and 3 Haemaphysalis spp. larva). The overall minimum field infection rate was 2.6%, whereas the minimum field infection rates of adult, nymphal, and larval ticks were 0%, 3.2%, and 2.0%, respectively. For a more accurate indication of the prevalence of SFTS virus in Korea, further in-depth investigations of tick species and SFTS virus occurrence over a larger area and longer period are needed.

Factors Potentially Associated with Chemotherapy-induced Anemia in Patients with Solid Cancers

  • Cheng, Ke;Zhao, Feng;Gao, Feng;Dong, Hang;Men, Hai-Tao;Chen, Ye;Li, Long-Hao;Ge, Jun;Tang, Jie;Ding, Jing;Chen, Xin;Du, Yang;Luo, Wu-Xia;Liu, Ji-Yan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5057-5061
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    • 2012
  • Purpose: Chemotherapy-induced anemia (CIA) is one of the most important causes of anemia in cancer patients. This study was conducted to describe the prevalence and characteristics of CIA in solid cancer patients in the Chinese population, and to explore the relationship of white blood cell (WBC) or platelet decrease with CIA. Methods: Data on age, gender, tumor diagnosis, anti-cancer treatment and blood cell analyses were available from 220 untreated non-anemic cancer patients who received at least 2 cycles of chemotherapy, and the data were analyzed to assess their relationship with CIA or its severity. Results: 139 patients (63.2%) presented anemia, most being Grade 1 or 2. Esophageal and lung cancers were associated with a high prevalence. G3/4 leucopenia and decrease of platelets were identified as independent risk factors for the occurrence of CIA. Moreover, G3/4 leucopenia, decrease of platelet and G3/4 thrombocytopenia were found to be also associated with the severity of CIA. Cisplatin-containing regimens were a main potential factor in causing CIA, although significant association was only found on univariate analysis. Conclusion: Anemia or decrease in hematoglobin are common in Chinese cancer patients receiving chemotherapy. Cisplatin-containing regimens might be an important factor influencing the occurrence of CIA. Our analysis firstly described some risk factors, such as decrease of platelets or WBCs, severity of leucopenia or thrombocytopenia, associated with the occurrence and severity of CIA.

A Case of Neonatal Alloimmune Thrombocytopenia due to Anti-HLA-B35 (항-HLA-B35 항체에 의한 신생아 동종면역성 혈소판 감소증 1례)

  • Choi, Jun-Seok;Kim, Soo-Yeon;Ihm, Chun-Hwa;Kim, Seung-Yeon
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.248-254
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    • 2009
  • Neonatal alloimmune thrombocytopenia (NAIT) is induced by maternal antibodies to fetal platelet alloantigens. Because the main cause of NAIT is incompatibility to platelet specific antibodies, NAIT due to HLA antibodies are relatively rare. We managed a case of NAIT induced by maternal anti-HLA-B35 antibodies. The patient was a second born male. He had no petechiae or purpura at birth. He was admitted to the hospital due to fever for 5 days and a platelet count of $106\times10^9/L$. The fever subsided after admission but on the 2nd day of admission, petechiae developed on the chest wall and the platelet count decreased to $25\times10^9/L$. Other laboratory findings included C-reactive protein, prothrombin time, and partial thromboplastin time were normal. His mother's platelet count was normal and she had no history of bleeding. Anti-HLA-B35, B52, B56, C3, and C14 were identified in the mother's serum by a panel reactive antibody test and HLA-B35 antigen was identified in the father's and patient's sera. These finding suggested that maternal Anti-HLA-B35 antibody was a response to neonatal HLA-B35 antigen inherited from the father. The patient received concentrated platelet and intravenous immunoglobulin. The platelet count rose to $248\times10^9/L$ and was maintained thereafter.

Necrotizing Enterocolitis in Term Infants (만삭아에 발생한 괴사성 장염)

  • Kim, Dae-Yeon;Kim, Seong-Chul;Kim, Kyung-Mo;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.9 no.1
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    • pp.19-23
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    • 2003
  • Necrotizing Enterocolitis (NEC) is usually a disease of premature infants, but occasionally it affects the term neonate. Twenty-five infants with NEC were treated at Asan Medical Center between January 2000 and December 2002, and 13 of them were term infants. In each case, the diagnosis of NEC was established by a clinical illness fulfilling the Bell's stage II or III NEC as modified by Walsh or by surgical findings. There were six males and seven females. The birth weight was from 1,960 to 3,700 g. The age at diagnosis was from 1 to 40 days. Four patients had congenital heart disease: one of who had hypothyroidism and cleft palate. Abdominal distension was present in all, and bloody stools in four. One patient had history of hypoglycemia, three had Rota viral infection. Eight patients had leucopoenia (<$5.0{\times}10^9/L$), seven had thrombocytopenia (<$100{\times}10^9/L$), and three severe thrombocytopenia (<$50{\times}10^9/L$). Laparotomy was required in 10 of the 13 patients. Indications for operation in the acute phase were failure to respond to aggressive medical therapy in five, and perforation in three patients. There were two late phase operations for intestinal stricture and fistula. There were no operative complications. Ten of thirteen patients survived (76.9%). Two patients died of septic complication. There was a delayed death due to heart failure. There was a significant difference in survival according to platelet count ($50{\times}10^9/L$) (p<0.05). Congenital heart disease and Rota viral infection are associated with NEC in term infants and thrombocytopenia and leucopoenia may be surgical indications.

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