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Parvovirus B19 Infection in Two Korean Pediatric Kidney Transplant Patients (소아에서 신장 이식 후 발생한 Parvovirus Bl9 감염 2례)

  • Koo, So-Eun;Lee, Joo-Hoon;Hahn, Hye-Won;Han, Duck-Jong;Park, Young-Seo
    • Childhood Kidney Diseases
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    • v.9 no.2
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    • pp.275-281
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    • 2005
  • Parvovirus B19(PV B19) is a nonenveloped single-stranded DNA virus that causes a wide variety of diseases ranging from benign childhood infection such as slapped-cheek rash(fifth disease) to life threatening diseases such as hydrous fetalis in fetuses or aplastic anemic crises in patients with hemolytic anemia. In immunocompromised hosts including organ transplant recipients, this infection can cause chronic anemia. Recently, the reports of cases of PV B19 infection have been increasing in transplant recipients and most reported cases of PV B19 infection-associated anemia in renal transplant recipients were successfully treated with intravenous immunoglobulin infusion. We experienced two cases of aplastic anemia caused by PV B19 infection in pediatric renal transplant recipients. The patients were an 8 year-old boy and 12-year-old boy who received allograft kidneys from their mothers. Anemia developed 2 weeks after transplantation and their serum was positive for PV B19 PCR. They were treated with 400 mg/kg of intravenous immunoglobulin(IVIG) for 5 consecutive days. In one of the case, anemia was corrected promptly after the first 5-day course of IVIG therapy but in the other, anemia persisted but responded to the second course of IVIG therapy. One year later, the patients have normal hematocrit levels and stable renal function These are the first cases of PV B19 infection treated successfully with IVIG in pediatric renal transplant recipients in Korea. (J Korean Soc Pediatr Nephrol 2005;9:275-281)

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Pyridoxine responsive sideroblastic anemia in a boy with mitral valve prolapse (승모판 탈출증을 가진 소아에서 Pyridoxine 반응성 철적모구성 빈혈 1례)

  • Sung, June Seung;Kim, Ki Hwan;Han, Dong Gyun;Kim, Mi Jeong;Cho, Young Kook;Chung, Hae Yul;Baek, Hee Jo;Ma, Jae Sook;Kook, Hoon;Hwang, Tai Ju
    • Clinical and Experimental Pediatrics
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    • v.49 no.11
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    • pp.1223-1226
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    • 2006
  • Sideroblastic anemia is a rare, heterogeneous group of disorders characterized by hyperferremia, microcytic hypochromic anemia, and bone marrow erythroid hyperplasia with the presence of numerous ringed sideroblasts. We describe herewith the case of a rare coincidence of sideroblastic anemia and mitral valve prolapse with resultant regurgitation in a 2-year-old boy. In addition to the inherent propensity for the development of cardiac dysfunction in sideroblastic anemia due to transfusion-associated myocardial iron overload and chronic anemia, a coincidence of MVP will further increase the likelihood of the morbidity or mortality of th patient. in this patient. After response to pyridoxine, the patient remains in good condition with stable hemoglobin levels.

Prognostic Significance of Preoperative Anemia, Leukocytosis and Thrombocytosis in Chinese Women with Epithelial Ovarian Cancer

  • Chen, Ying;Zhang, Lei;Liu, Wen-Xin;Liu, Xiang-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.933-939
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    • 2015
  • Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8%. Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ${\geq}1cm$, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all p<0.05). Moreover, EOC patients with older age or postmenopausal EOC patients had the higher prevalence of thrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (p<0.001). Conclusively, preoperative anemia, leukocytosis or thrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease-specific survival for EOC patients.

A clinical case study of chronic inflammatory anemia in post-symptom period resulting Stroke of Soeumin patient (소음인환자(少陰人患者)의 중풍후유기(中風後遺期)에 병발(倂發)한 만성(慢性) 염증성(炎症性) 빈혈(貧血)에 대한 증례(症例))

  • Park, Eun-kyung;Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.377-383
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    • 1999
  • The anemia which is accompanied with chronic primary diseases has been showed most frequently in the clinic. The purpose of this study is to give an account of the effects of the Korean herbal medicine therapy which is based on the constitutional medicine for the patient who has suffered from mild anemia, pneumonia and general depressed condition in the chronic stage of post-cerebellar hemorrhage. The subject is a 75-year-old woman who has had the symptoms caused by hemorrhage, which are headache, dizziness, walking disturbance, dysphasia, and general weakness and so forth. Therefore, she has normocytic normochromic anemia in the hematomancy. We have diagnosed her as Soeumin(少陰人) Ulkwangjeung(鬱狂症) and have prescribed Palmulgunjatang(八物君子湯) in accordance with the principle of Seungyangikgi(升陽益氣). The consequence is that the accompanied anemia and genseal depressed condition have improved.

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Helicobacter pylori Infection is a Risk Factor for Iron-Deficiency Anemia in Korean High School Girls

  • Hong, Soon-Myung;Hwang, Hye-Jin;Park, Sang-Kyu
    • Preventive Nutrition and Food Science
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    • v.8 no.1
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    • pp.70-74
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    • 2003
  • This study investigated the relationship of Helicobacter pylori (H. pylori) infection to iron-deficiency anemia in high school girls. Four hundred and fourty-five subjects resided in Ulsan City in Korea were evaluated by questionnaire or blood analysis for serum indicators of iron status, daily nutrient intakes, symptoms of anemia, and H. pylori IgG antibody status. In H. pylori infected subjects, total energy intake of was 1534.14±350.81 kcal (73.0% of the Korean RDA), the iron intake of subjects was 11.38±3.90 mg (71.1% of Korean RDA) and calcium intake was 467.63±175.96 mg (58.3% of the Korean RDA). Carbohydrate (p < 0.05), vitamin A (p < 0.05), vitamin C (p < 0.01) intakes were significantly lower in infected subjects than in non-infected subjects. The prevalence of anemia (hemoglobin (Hb) < 12 g/dL.) in H. pylori infected subjects was 22.7% as compared to 14.7% in non-infected subjects. The mean serum ferritin of infected subjects (21.71±21.50 ng/mL) was significantly lower than in non-infected subjects (p < 0.05) (as was the mean Hb concentration (12.54±1.51 g/dL) and hematocrit (37.99±3.64%)). Total iron binding capacity (TIBC) of H. pylori infected subjects (449.09±78.23 ㎍/dL) was significantly higher than that of non-infected subjects (432.99+76.15 ㎍/dL) (P < 0.05). The levels of iron, red blood cell (RBC) and transferrin saturation were similar in infected and non-infected subjects. Two symptoms of anemia, 'pale face (p < 0.01)' and 'decreased ability to concentrate (p < 0.005)', were significantly higher in H. pylori infected subjects than in non-infected subjects. High school girls are known to be more vulnerable to iron deficiency than other age groups, and this research demonstrates that infection with H. pylori increases their risk of iron-deficiency anemia.

Chemotherapeutic Response and Survival for Patients With an Anal Squamous Cell Carcinoma and Low Hemoglobin Levels

  • Naqvi, A.;Platt, E.;Jitsumura, M.;Evans, M.;Coleman, M.;Smolarek, S.
    • Annals of Coloproctology
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    • v.34 no.6
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    • pp.312-316
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    • 2018
  • Purpose: Anemia is associated with poor treatment results for a variety of cancers. The effect of low hemoglobin levels on long-term outcomes after the treatment of patients with an anal squamous cell carcinoma (SCC) remains unclear. For that reason, this study aimed to investigate the effect of anemia on treatment outcomes following chemoradiation for an anal SCC. Methods: This was a retrospective study of all patients who underwent curative treatment for an anal SCC between 2009 and 2015 at 2 trusts in the United Kingdom. Data were collated from prospectively collected cancer databases and were cross-checked with operating-room records and records in the hospitals' patient management systems. Results: We identified 103 patients with a median age of 63 years (range, 36-84 years). The median overall survival was 39 months (range, 9-90 months), and the disease-free survival was 36 months (range, 2-90 months). During the follow-up period, 16.5% patients died and 13.6% patients developed recurrence. Twenty-two people were anemic prior to treatment, with a female preponderance (20 of 22). No differences in disease-free survival (P = 0.74) and overall survival (P = 0.12) were noted between patients with anemia and those with normal hemoglobin levels. On regression the analysis, the combination of anemia, the presence of a defunctioning colostomy, lymph-node involvement and higher tumor stage correlated with poor overall survival. Conclusion: In this study, anemia did not influence disease-free survival or overall survival. We suggest that the interaction between anemia and survival is more complex than previously demonstrated and potentially reliant on other coexisting factors.

A Study on Nutritional Anemia of Pre-school Children in Korea (한국 미취학 아동의 영양성 빈혈에 관한 연구)

  • Tchai, B.S.;Chu, D.S.
    • Journal of Nutrition and Health
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    • v.4 no.1
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    • pp.1-19
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    • 1971
  • Nutritional anemia is an important nutritional problem affecting large population groups in most developing countries. Nutritional anemia is caused by the absence of any dietary essential involed in hemoglobin formation or by poor absorption of these dietary components. The most likely causes are lack of dietary iron, and folate, vitamin $B_{12}$ and high qualify protein. Anemia is considered to be a late mainfeastation of nutritional deficiencies, and even mild anemia is not the earilest sign of such a deficiency. Therefore, the object of therapy is to correct underlying deficiency rather than merely its manifestation. Iron deficiency anemia is generally much the most common form of anemia. And it is very prevalent particularly in pregnant women and young children, especially under five year of life. According to the rapid growth rate of infants, dietary iron should he provided for infants over three months of age in adequate amounts for the synthesis of hemoglobin required by the increasing blood volume and for the demands of newly formed cells. The principal causes of iron deficiency anemia are an inadequate dietary iron content, interference with absorption of iron from the intestine, excessive losses of iron from the body, disturbance of iron metabolism by infection, and social and cultural environments. The present study is planned to obtain informations concerning nutritional anemia through anthropometric and biochemical determinations for the assessment of nutriture in pre-school children. Determination was taken in 226 pre-school children in ruraI arae in 1968, 122 pre-school children in 1970, and 1526 hospitalized pre-school children in 1970. The results of this study are as follows; (1) According to Iowa Malnutrition Borderline (85 percentile) for weight, the proportions of underweighed pre-school boys and girls in rural area were 47.2% and 46.2% in1968, and were 36.1% and 51.8% in 1970. According to Iowa Malnutrition Borderline for height, the proportions of underheight boys and girls in rural area were 30.5% and 33.7%, and were 26.2% and 21.8% in 1970. Malnutrition scores of underweight for height values of boys and girls in rural area were 19.3 and 17.3 in 1968, and the scores of boys and girls were 15.6 and 15.5 in 1970. (2) The mean hemoglobin values of boys and girls in rural area were $11.2{\pm}1.8g/100ml\;and\;11.4{\pm}1.6g/100ml$ in 1968. In 1970, the mean values of boys and girls in rural area were $11.3{\pm}1.3g/100ml\;and\;11.7{\pm}2.4g/100ml$. The mean hemoglobin values of hospitalized boys and girls were $11.9{\pm}2.2g/100ml\;and\;11.7{\pm}2.4g/100ml$ in 1970. It is found that 92 of 215 children (42.7%) in rural area had concentrations of hemoglobin less than 11.0g/100ml in 1968. In 1970, 55 of 121 children (45.4%) in rural area and 559 of 1526 hospitalized children (36.6%) had concentrations of hemoglobin less than 11.0g/100ml. (3) The mean hematocrit levels of hospitalized boys and girls were $35{\pm}26.8%\;and\;35.4{\pm}6.4%$ in 1970. And 443 of 1334 hospitalized children (33.2%) had hematocrit values below 33%. (4) The average mean corpuscular hemoglobin concentration levels of hospitalized boys and girls were $32.4{\pm}2.2\;and\;32.3{\pm}2.2$ in 1970. And 1016 of 1352 hospitalized children (75.1%) had the mean corpuscular hemoglobin values below 34. (5) The mean iron values of young children in rural area and hospitalized children were $62.0{\pm}6.3{\mu}g/100ml\;and\;60.7{\pm}22.8{\mu}g/100ml$. The proportions of anemia cases below $50{\mu}g/100ml$ in rural area was 37.9%, and 34.3% in hospitalized children. (6) The mean total iron binding capacity of young children in rural area was $376{\pm}57.88{\mu}g/100ml,\;and\;342.2{\pm}6.15{\mu}g/100ml$ in hospitalized children. (7) The average transferrin saturation percentage of young children in rural area was $16.9{\pm}4.7%,\;and\;18.0{\pm}8.4%$ in hospitalized children. The proportions of anemia cases below 15% of young chi1dren in rural area and hospitalized children were 48.3% and 41.2%. Therefore, authors wish to recommend that the following further studies should be undertaken: (1) Standardization of simplied laboratory examination of nutritional anemia. (2) The prevalence of nutritional anemia and the requirements of iron, folate, and vitamin $B_{12}$ of pre-school children. (3) The content and absorption of iron in Korean food. (4) The pathogenesis of nutritional anemia and prevention of parasitic disease. (5) Maternal health and nutrition education.

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Aplastic anemia (재생불량빈혈(Aplastic anemia))

  • Kim, Hack Ki
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.519-523
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    • 2007
  • Aplastic anemia is a rare disease, which is characterized by pancytopenia and hypocellular bone marrow without infiltration of abnormal cells or fibrosis. The incidence in Asia is higher than in the West and new cases are diagnosed at a rate of 5.1 per million pediatric populations per year in Korea. The pathophysiology is understood roughly by defective hematopoiesis, impaired bone marrow micro-environment and immune mechanism. Treatments are performed on basis of pathogenesis and selected depending on the severity. Immunosuppressive therapy with antilymphocyte or antithymocyte globulin and cyclosporine is effective in the majority of patients but has some problems including relapse or clonal evolution. Recently, there have been clinical trials of immunosuppression with hematopoietic growth factors or other drugs. Allogeneic hematopoietic stem cell transplantation (HSCT) is curative in children with severe aplastic anemia. The overall survival in HSCT from HLA-identical sibling is higher than alternative donor, including HLA matched unrelated donor or cord blood. We have to consider quality of life after HSCT because of high survival rate. However, chronic graft versus host disease and graft failure are important factors that affect the quality of life and overall survival. We need further investigation to make new regimens aimed at overcoming these risk factors and perform clinical trials.

1 Case of Iron Deficiency Anemia treated with Gwibitang(歸脾湯) plus(合) Samultang(四物湯) in the Patient of Cerebral Hemorrhage (뇌출혈(腦出血) 환자의 철결핍성(鐵缺乏性) 빈혈(貧血)을 귀비탕합사물탕(歸脾湯合四物湯)으로 치료한 임상(臨床) 1례(例))

  • Ko, Hyun;An, Hyo-Myug;Hwang, Kyu-Dong;Lee, Eun-Suk
    • The Journal of Internal Korean Medicine
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    • v.21 no.5
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    • pp.877-881
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    • 2000
  • Anemia is present in adult if the hematocrit is less than 41%(hemoglobin <13.5g/dL) in males or 37%(hemoglobin <12g/dL) in females. In taking the history, congenital anemia may be suggested by the patient's personal and family history. Poor diet results in folic acid deficiency and may contribute to iron deficiency. Bleeding should always be considered in iron deficiency. Object : The symptoms of this patient are easy fatigability, dizziness, anorexia and paleness of the face. This women is the patient of iron deficiency anemia, cerebral hemorrhage and hypertension. Medication : Gwibitang(歸脾湯) plus(合) Samultang(四物湯) and feroba are dispensed for 30 days. Result : After 30 days, HCT Hb Iron of the laboratory findings are increased and TIBC of the laboratory findings is decreased.

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